Individual provider Active NPI

Laura Marie Phillips, M.A., LMFT

  • Marriage & Family Therapist
  • Stillwater, MN
National Provider Identifier
1295836559
Registry record updated Feb 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1496 Issued in MN
Practice address
116 Chestnut St E
Suite 400
Stillwater, MN 55082-5116
Phone
(651) 344-6204
Fax
(651) 344-4949
NPI assigned
Sep 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 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 1496 MN Primary

Addresses

Primary practice location

116 Chestnut St E
Suite 400
Stillwater, MN 55082-5116

Mailing address

116 Chestnut St E
Suite 400
Stillwater, MN 55082-5116
Phone (651) 344-6204

Other identifiers 1

IdentifierTypeStateIssuer
1295836559MedicaidMN

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

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266364800000",
    "number": "1295836559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 CHESTNUT ST E",
            "address_2": "SUITE 400",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550825116",
            "telephone_number": "651-344-6204",
            "fax_number": "651-344-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 CHESTNUT ST E",
            "address_2": "SUITE 400",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550825116",
            "telephone_number": "651-344-6204",
            "fax_number": "651-344-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "LAURA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "M.A., LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2010-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295836559",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2010; 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.