Individual provider Active NPI

Anna Katherine Barlage, LMFT

  • Marriage & Family Therapist
  • Long Lake, MN
National Provider Identifier
1114304052
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2818 Issued in MN
Practice address
1850 W Wayzata Blvd Ste 240
Long Lake, MN 55356-9491
Phone
(952) 250-2359
Fax
(763) 306-0003
NPI assigned
Apr 29, 2015
Last updated
Nov 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 2818 MN Primary

Addresses

Primary practice location

1850 W Wayzata Blvd Ste 240
Long Lake, MN 55356-9491

Mailing address

1850 W Wayzata Blvd Ste 240
Long Lake, MN 55356-9491
Phone (952) 250-2359

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: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2818MNMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Anna Barlage LMFT PLLC Marriage & Family Therapist CurrentSince Nov 9, 2021 Accepting new patients
Psychotherapy & Healing Associates PastSince Jul 28, 2019 Accepting new patients

Locations

1850 W Wayzata Blvd
Ste 240
Long Lake, MN 55356
Phone (952) 250-2359

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1114304052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 W WAYZATA BLVD STE 240",
            "city": "LONG LAKE",
            "state": "MN",
            "postal_code": "553569491",
            "telephone_number": "952-250-2359",
            "fax_number": "763-306-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 W WAYZATA BLVD STE 240",
            "city": "LONG LAKE",
            "state": "MN",
            "postal_code": "553569491",
            "telephone_number": "952-250-2359",
            "fax_number": "763-306-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARLAGE",
        "first_name": "ANNA",
        "middle_name": "KATHERINE",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-29",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Lake, MN

Sources for this page

Verify at the official NPI Registry.