Marisa Ray Macho Gagner, M.A.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

4108 Issued in MN

Practice address

603 Bruce St
Crookston, MN 56716-2914

Phone

(218) 281-3940

NPI assigned

Apr 13, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Alluma, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Crookston, MN
  • NPI 1508835133
  NPD

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1225253594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 BRUCE ST",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567162914",
            "telephone_number": "218-281-3940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 BRUCE ST",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567162914",
            "telephone_number": "218-281-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACHO GAGNER",
        "first_name": "MARISA",
        "middle_name": "RAY",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "4108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "CredibleBH.com",
            "affiliation": "N",
            "endpointDescription": "online HIE",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "603 Bruce St",
            "city": "Crookston",
            "state": "MN",
            "country_code": "US",
            "postal_code": "567162914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Richard A Lochner, D.P.M.
• Christine Jane Loff, PT
• Marla Rae Love, LRD
• Mandy Leeann Lundby, LICSW
• Lutheran Social Service of Minnesota
• Daniel Avila Magana, D.P.T.
• Janae Magana, DPT
• Rosa Maria Martinez
• Solomonia I Martushoff
• Crystal Maruska, OTR

• Marriage & Family Therapist in Crookston, MN
• Providers in Crookston, 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 Aug 5, 2026; 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.