Bernie Jerome Menge, MA. LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

3335 Issued in MN

Practice address

1303 S Frontage Rd Ste 275
Hastings, MN 55033

Phone

(651) 319-6484

Fax

(651) 925-0442

NPI assigned

Jan 18, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Family Revelations Inc.

  • Adult Mental Health Clinic/Center
  • Maplewood, MN
  • NPI 1790212926
  Medicare reassignment NPD Authorized official
• Lionheart Wellness and Recovery

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Hastings, MN
  • NPI 1104606607
  Medicare reassignment NPD

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1134490469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 S FRONTAGE RD STE 275",
            "city": "HASTINGS",
            "state": "MN",
            "postal_code": "550332655",
            "telephone_number": "651-319-6484",
            "fax_number": "651-925-0442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 S FRONTAGE RD STE 275",
            "city": "HASTINGS",
            "state": "MN",
            "postal_code": "55033",
            "telephone_number": "651-319-6484",
            "fax_number": "651-925-0442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1705 Cope Ave E Ste I",
            "address_purpose": "LOCATION",
            "city": "Maplewood",
            "state": "MN",
            "postal_code": "551092639",
            "country_code": "US",
            "telephone_number": "651-319-6484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENGE",
        "first_name": "BERNIE",
        "middle_name": "JEROME",
        "credential": "MA. LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-18",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113449046",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790212926",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordan McGowan
• Dena L McGree, O.D.
• Melody Lenore McKenzie, MD
• Thomas V Mears, MD
• Robert Melson
• Michael W Ahn DDS PA
• Katie Mikla, MS, CCC-SLP
• Cailin Miller, RD, MS
• Daniel James Miller, ATC
• Milliren Family Dentistry

• Marriage & Family Therapist in Hastings, MN
• Providers in Hastings, 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 Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.