Individual provider Active NPI

Pamela Walz, LMFT

  • Marriage & Family Therapist
  • Little Falls, MN
National Provider Identifier
1336690023
Registry record updated Oct 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
3023 Issued in MN
Practice address
16016 233Rd St
Little Falls, MN 56345-5583
Phone
(320) 632-5524
Fax
(888) 991-2741
NPI assigned
Oct 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2016

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 3023 MN Primary

Addresses

Primary practice location

16016 233Rd St
Little Falls, MN 56345-5583

Mailing address

16016 233Rd St
Little Falls, MN 56345-5583
Phone (320) 632-5524

Other names 1

  • Pamela Fuchs Professional name

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
I20240516000584 MN Practitioner - Marriage and Family Therapist 1951742311 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3023MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ellison Center Marriage & Family Therapist CurrentSince Mar 1, 2024 Accepting new patients
True Balance LTD Marriage & Family Therapist PastSince May 20, 2008 Accepting new patients

Locations

600 25th Ave S
Ste 102
Saint Cloud, MN 56301
Phone (320) 310-6365

Organizations & group practices 2

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": "1476748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476748800000",
    "number": "1336690023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16016 233RD ST",
            "city": "LITTLE FALLS",
            "state": "MN",
            "postal_code": "563455583",
            "telephone_number": "320-632-5524",
            "fax_number": "888-991-2741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16016 233RD ST",
            "city": "LITTLE FALLS",
            "state": "MN",
            "postal_code": "563455583",
            "telephone_number": "320-632-5524",
            "fax_number": "888-991-2741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALZ",
        "first_name": "PAMELA",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-18",
        "last_updated": "2016-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "FUCHS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Little Falls, MN

Sources for this page

Verify at the official NPI Registry.