Active NPI
Lauren Joy Roos, LMFT
- Marriage & Family Therapist
- Brainerd, MN
National Provider Identifier
1114409661
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 3311
- Practice address
- 617 Oak St
Brainerd, MN 56401-3610 - Phone
- (218) 829-7140
- Fax
- (218) 829-7124
- NPI assigned
- Aug 31, 2018
- Sex
- Female
- Sole proprietor
- No
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 | 3311 | MN | Primary |
Addresses
Primary practice location
617 Oak St
Brainerd, MN 56401-3610
Mailing address
617 Oak St
Brainerd, MN 56401-3610
Phone (218) 829-7140
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3311 | MN | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Core Professional Services, P.a. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychologist
- Brainerd, MN
- NPI 1841382108
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535673600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535673600000",
"number": "1114409661",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "617 OAK ST",
"city": "BRAINERD",
"state": "MN",
"postal_code": "564013610",
"telephone_number": "218-829-7140",
"fax_number": "218-829-7124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "617 OAK ST",
"city": "BRAINERD",
"state": "MN",
"postal_code": "564013610",
"telephone_number": "218-829-7140",
"fax_number": "218-829-7124"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROOS",
"first_name": "LAUREN",
"middle_name": "JOY",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-31",
"last_updated": "2018-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "3311",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brainerd, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.