Ann Marie Conrad, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC00228 Issued in MN

Practice address

8640 Eagle Creek Circle
Savage, MN 55378

Phone

(952) 746-7664

Fax

(952) 746-0582

NPI assigned

Jan 26, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ann Marie Fasnacht Former name

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

River Valley Behavioral Health and Wellness Center, PLLCGroup PAC ID 3678625035, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• River Valley Behavioral Health & Wellness Center, PLLC

  • Counseling Psychologist
  • Savage, MN
  • NPI 1316197148
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1296000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433462400000",
    "number": "1093011827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8640 EAGLE CREEK CIRCLE",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "55378",
            "telephone_number": "952-746-7664",
            "fax_number": "952-746-0582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8640 EAGLE CREEK CIRCLE",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "55378",
            "telephone_number": "952-746-7664",
            "fax_number": "952-746-0582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "ANN",
        "middle_name": "MARIE",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-26",
        "last_updated": "2015-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC00228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "FASNACHT",
            "middle_name": "MARIE",
            "credential": "LPCC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Mental Health Counselor in Savage, MN
• Providers in Savage, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.