Active NPI
Melanie Koenen
- Marriage & Family Therapist
- Little Canada, MN
National Provider Identifier
1306498720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 2864 Middle St Ste 100
Little Canada, MN 55117-1411 - Phone
- (651) 493-2055
- NPI assigned
- Jul 16, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Marriage & Family Therapist | 106H00000X | Primary |
Addresses
Primary practice location
2864 Middle St Ste 100
Little Canada, MN 55117-1411
Mailing address
2864 Middle St Ste 100
Little Canada, MN 55117-1411
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peak Behavioral Health, LLC | Mental Health | 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.
-
- Marriage & Family Therapist
- Little Canada, MN
- NPI 1053879023
Mental Health
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563235200000",
"number": "1306498720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2864 MIDDLE ST STE 100",
"city": "LITTLE CANADA",
"state": "MN",
"postal_code": "551171411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2864 MIDDLE ST STE 100",
"city": "LITTLE CANADA",
"state": "MN",
"postal_code": "551171411",
"telephone_number": "651-493-2055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOENEN",
"first_name": "MELANIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-16",
"last_updated": "2019-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Little Canada, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.