Individual provider Active NPI

Edi Swartz Connor, MS, LMFT

  • Marriage & Family Therapist
  • Minnetonka, MN
National Provider Identifier
1144543570
Registry record updated Mar 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1689 Issued in MN
Practice address
16816 Blenheim Way
Minnetonka, MN 55345-2715
Phone
(952) 484-8485
NPI assigned
Mar 12, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2010

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 1689 MN Primary

Addresses

Primary practice location

16816 Blenheim Way
Minnetonka, MN 55345-2715

Mailing address

16816 Blenheim Way
Minnetonka, MN 55345-2715
Phone (952) 484-8485

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240612001096 MN Practitioner - Marriage and Family Therapist 3577005040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Soul Work Counseling, LLCGroup PAC ID 4789910233, 12 clinicians

Practice addresses (Care Compare)

11925 Central Ave NE
Blaine, MN 55434-3911
Phone (763) 746-0891

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1689MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Soul Work Counseling, LLC CurrentSince Apr 13, 2024 Accepting new patients

Locations

11188 Zealand Ave N
Champlin, MN 55316
Phone 7637460842 ext. 1

11925 Highway 65 NE
Minneapolis, MN 55434
Phone (763) 746-0842

10520 Wayzata Blvd
Ste 100
Minnetonka, MN 55305
Phone (612) 819-2750

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.

NPI Registry JSON

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

{
    "created_epoch": "1268352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268352000000",
    "number": "1144543570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16816 BLENHEIM WAY",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553452715",
            "telephone_number": "952-484-8485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16816 BLENHEIM WAY",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553452715",
            "telephone_number": "952-484-8485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOR",
        "first_name": "EDI",
        "middle_name": "SWARTZ",
        "name_prefix": "Ms.",
        "credential": "MS, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-12",
        "last_updated": "2010-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

Verify at the official NPI Registry.