Individual provider Active NPI

Katia R Lopez-Petrovich, M.S.,NCC., LMFT

  • Marriage & Family Therapist
  • Saint Paul, MN
National Provider Identifier
1154645083
Registry record updated May 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2238 Issued in MN
Practice address
821 Raymond Ave Ste 230a
Saint Paul, MN 55114-1550
Phone
(612) 702-3483
Fax
(612) 545-4988
NPI assigned
Mar 22, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2018

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 2238 MN Primary

Addresses

Primary practice location

821 Raymond Ave Ste 230a
Saint Paul, MN 55114-1550

Mailing address

4471 Highway 10
Arden Hills, MN 55112-1952
Phone (612) 702-3483

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 Science

State licenses

LicenseStateTypeSpecialty
2238MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Multicultural Psychotherapy and Consulting Services LTD Marriage & Family Therapist 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.

NPI Registry JSON

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

{
    "created_epoch": "1269216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525824000000",
    "number": "1154645083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4471 HIGHWAY 10",
            "city": "ARDEN HILLS",
            "state": "MN",
            "postal_code": "551121952",
            "telephone_number": "612-702-3483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 RAYMOND AVE STE 230A",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141550",
            "telephone_number": "612-702-3483",
            "fax_number": "612-545-4988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ-PETROVICH",
        "first_name": "KATIA",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "M.S.,NCC., LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-22",
        "last_updated": "2018-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.