Active NPI
Carol Lee Brown, MA, LMFT
- Marriage & Family Therapist
- Minnetonka, MN
National Provider Identifier
1154583334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 1610
- Practice address
- 13911 Ridgedale Dr Ste 460
Minnetonka, MN 55305-1777 - Phone
- (651) 439-2059
- Fax
- (888) 675-8262
- NPI assigned
- Jun 27, 2008
- 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 | 1610 | MN | Primary |
Addresses
Primary practice location
13911 Ridgedale Dr Ste 460
Minnetonka, MN 55305-1777
Mailing address
13911 Ridgedale Dr Ste 460
Minnetonka, MN 55305-1777
Phone (651) 439-2059
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154583334 | Medicaid | MN |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1610 | MN | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rush Inc | 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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524528000000",
"number": "1154583334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13911 RIDGEDALE DR STE 460",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553051777",
"telephone_number": "651-439-2059",
"fax_number": "888-675-8262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13911 RIDGEDALE DR STE 460",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553051777",
"telephone_number": "651-439-2059",
"fax_number": "888-675-8262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "CAROL",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"credential": "MA, LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-27",
"last_updated": "2018-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "1610",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1154583334",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minnetonka, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.