Active NPI
Melissa Kathleen Bergdall, M.S., LAMFT
- Marriage & Family Therapist
- Minneapolis, MN
National Provider Identifier
1083064414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 3283
- Practice address
- 2945 44TH Ave S
Suite 2
Minneapolis, MN 55406-1826 - Phone
- (612) 568-8393
- NPI assigned
- Jun 16, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 3283 | MN | Primary |
Addresses
Primary practice location
2945 44TH Ave S
Suite 2
Minneapolis, MN 55406-1826
Mailing address
2945 44TH Ave S
Suite 2
Minneapolis, MN 55406-1826
Phone (612) 568-8393
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3283 | MN | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466035200000",
"number": "1083064414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2945 44TH AVE S",
"address_2": "SUITE 2",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554061826",
"telephone_number": "612-568-8393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2945 44TH AVE S",
"address_2": "SUITE 2",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554061826",
"telephone_number": "612-568-8393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGDALL",
"first_name": "MELISSA",
"middle_name": "KATHLEEN",
"credential": "M.S., LAMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-16",
"last_updated": "2016-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "3283",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.