The Minnesota Center for Couples and Family Therapy, LLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

THE MINNESOTA CENTER FOR COUPLES AND FAMILY THERAPY, LLC

Practice address

1120 E 80TH St
Suite 200
Bloomington, MN 55420-1462

Phone

(952) 767-0442

NPI assigned

Jul 24, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Roger A Ballou, PHD, LMFT

Title

Co-Owner

Phone

(651) 246-7592

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343088000000",
    "number": "1093061301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 E 80TH ST",
            "address_2": "SUITE 200",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554201462",
            "telephone_number": "952-767-0442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 E 80TH ST",
            "address_2": "SUITE 200",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554201462",
            "telephone_number": "952-767-0442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MINNESOTA CENTER FOR COUPLES AND FAMILY THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-24",
        "last_updated": "2012-07-24",
        "status": "A",
        "authorized_official_last_name": "BALLOU",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "651-246-7592",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.