Individual provider Active NPI

Tyra Hughes, MA, LMFT

  • Marriage & Family Therapist
  • St Louis Park, MN
National Provider Identifier
1316334535
Registry record updated Apr 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2807 Issued in MN
Practice address
1660 Highway 100 S
Suite 330
St Louis Park, MN 55416-1529
Phone
(952) 224-0399
Fax
(952) 224-0396
NPI assigned
Apr 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2015

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 2807 MN Primary

Addresses

Primary practice location

1660 Highway 100 S
Suite 330
St Louis Park, MN 55416-1529

Mailing address

1660 Highway 100 S
Suite 330
St Louis Park, MN 55416-1529
Phone (952) 224-0399

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
I20240524001457 MN Practitioner - Marriage and Family Therapist 2163864968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Parkdale Therapy Group, LLCGroup PAC ID 8921355496, 3 clinicians

Practice addresses (Care Compare)

1000 Shelard Pkwy
Suite 520
Saint Louis Park, MN 55426-4932
Phone (952) 224-0399

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2807MNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Parkdale Therapy Group, LLC Marriage & Family Therapist CurrentSince May 1, 2024 Accepting new patients

Locations

1684 Selby Ave
Saint Paul, MN 55104
Phone (651) 206-8955

1660 Highway 100 S
Ste 330
St Louis Park, MN 55416
Phone (651) 621-0688

1000 Shelard Pkwy
Ste 520
St Louis Park, MN 55426
Phone (952) 224-0399

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": "1430006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430006400000",
    "number": "1316334535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 HIGHWAY 100 S",
            "address_2": "SUITE 330",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161529",
            "telephone_number": "952-224-0399",
            "fax_number": "952-224-0396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 HIGHWAY 100 S",
            "address_2": "SUITE 330",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161529",
            "telephone_number": "952-224-0399",
            "fax_number": "952-224-0396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUGHES",
        "first_name": "TYRA",
        "credential": "MA, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-26",
        "last_updated": "2015-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.