Marissa Mitchell, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1709 Issued in MN

Practice address

1500 McAndrews Rd W Ste 227
Burnsville, MN 55337-4447

Phone

(952) 892-8402

Fax

(952) 892-8402

NPI assigned

Jan 8, 2009

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1231372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1124265491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 MCANDREWS RD W STE 227",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553374447",
            "telephone_number": "952-892-8402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 MCANDREWS RD W STE 227",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553374447",
            "telephone_number": "952-892-8402",
            "fax_number": "952-892-8402"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3450 OLeary Ln",
            "address_purpose": "LOCATION",
            "city": "Eagan",
            "state": "MN",
            "postal_code": "551232340",
            "country_code": "US",
            "telephone_number": "651-454-0114",
            "fax_number": "651-454-3492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "MARISSA",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-08",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124265491",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Burnsville, MN
• Providers in Burnsville, 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 Mar 17, 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.

Verify at the official NPI Registry.