Individual provider Active NPI

Ethel Nahmad-Faith, MA, LMFT

  • Marriage & Family Therapist
  • Minneapolis, MN
National Provider Identifier
1215364757
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2388 Issued in MN
Practice address
2 E Franklin Ave Ste 1a
Minneapolis, MN 55404-2557
Phone
(612) 384-5602
Fax
(612) 465-4567
NPI assigned
Sep 30, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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 2388 MN Primary

Addresses

Primary practice location

2 E Franklin Ave Ste 1a
Minneapolis, MN 55404-2557

Mailing address

5155 Xerxes Ave S
Minneapolis, MN 55410-2255
Phone (612) 384-5602

Other identifiers 1

IdentifierTypeStateIssuer
1518053834MedicaidMN

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
I20240820003427 MN Practitioner - Marriage and Family Therapist 0042758104 Reassigns benefits to 1 organization
Practice locations: Minneapolis, MN

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2388MNMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Amherst H. Wilder Foundation CurrentSince Aug 5, 2024 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": "1380499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1215364757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5155 XERXES AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554102255",
            "telephone_number": "612-384-5602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 E FRANKLIN AVE STE 1A",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554042557",
            "telephone_number": "612-384-5602",
            "fax_number": "612-465-4567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAHMAD-FAITH",
        "first_name": "ETHEL",
        "name_prefix": "Mrs.",
        "credential": "MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-30",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518053834",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.