Liese Fredericka Von Brauchitsch, MA, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

2705 Issued in MN

Practice address

2900 Piedmont Ave
2900 Piedmont Ave
Duluth, MN 55811-2915

Phone

(218) 740-7618

NPI assigned

Jun 14, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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

• Thrive Behavioral Network II, LLC

  • Physical Disabilities Residential Treatment Facility
  • Duluth, MN
  • NPI 1275955270
  NPD (past)

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557100800000",
    "number": "1104276880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 BURNING TREE ROAD",
            "address_2": "BURCH TREE CENTER",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55811",
            "telephone_number": "218-623-1812",
            "fax_number": "218-623-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 PIEDMONT AVE",
            "address_2": "2900 PIEDMONT AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558112915",
            "telephone_number": "218-740-7618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VON BRAUCHITSCH",
        "first_name": "LIESE",
        "middle_name": "FREDERICKA",
        "name_prefix": "Ms.",
        "credential": "MA, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-14",
        "last_updated": "2019-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Lynn Voight, PA-C
• Rachel Hope Voigt, CPM, LM
• Nichollette Leigh Volle
• Cassandra Dannelle Voltzke
• Tabitha Voltzke, RDH
• Grace Vonesh
• Jodi Vonville, LADC
• Vop Duluth Heights Lodge, LLC
• John Peter Vorderbruggen, OPTICIAN
• Amber Jean Voss, PA-C

• Marriage & Family Therapist in Duluth, MN
• Providers in Duluth, 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 May 6, 2019; 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.