Active NPI
Samantha Rose Waldron, LAMFT
- Marriage & Family Therapist
- Saint Louis Park, MN
National Provider Identifier
1083405039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 4746
- Practice address
- 1000 Shelard Pkwy Ste 520
Saint Louis Park, MN 55426-4932 - Phone
- (612) 987-4855
- NPI assigned
- May 16, 2025
- 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 | 4746 | MN | Primary |
Addresses
Primary practice location
1000 Shelard Pkwy Ste 520
Saint Louis Park, MN 55426-4932
Mailing address
1000 Shelard Pkwy Ste 520
Saint Louis Park, MN 55426-4932
Phone (612) 987-4855
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747353600000",
"number": "1083405039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 SHELARD PKWY STE 520",
"city": "SAINT LOUIS PARK",
"state": "MN",
"postal_code": "554264932",
"telephone_number": "612-987-4855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 SHELARD PKWY STE 520",
"city": "SAINT LOUIS PARK",
"state": "MN",
"postal_code": "554264932",
"telephone_number": "612-987-4855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDRON",
"first_name": "SAMANTHA",
"middle_name": "ROSE",
"credential": "LAMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-05-16",
"last_updated": "2025-05-16",
"certification_date": "2025-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "4746",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.