Individual provider Active NPI

Diane Lynn Hovey

  • Marriage & Family Therapist
  • White Bear Lake, MN
National Provider Identifier
1366770406
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1967 Issued in MN
Practice address
4505 White Bear Pkwy Ste 1500
White Bear Lake, MN 55110
Phone
(651) 493-8150
Fax
(651) 493-9335
NPI assigned
Dec 1, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1967 MN Primary
Poetry Therapist 102X00000X C2007-105

Addresses

Primary practice location

4505 White Bear Pkwy Ste 1500
White Bear Lake, MN 55110

Mailing address

4505 White Bear Pkwy Ste 1500
White Bear Lake, MN 55110-3697
Phone (651) 493-8150

Other practice location 1

3640 Talmage Circle
Suite 210
Vadnais Heights, MN 55110-7100
Phone (651) 470-4671

Other identifiers 1

IdentifierTypeStateIssuer
1366770406MedicaidMN

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

OrganizationSpecialtyStatusNew patients
Alliance for Healing PA Marriage & Family Therapist CurrentSince Oct 6, 2015 Accepting new patients

Locations

3640 Talmage Cir
Ste 210
Vadnais Heights, MN 55110
Phone (651) 493-8150

4505 White Bear Pkwy
Ste 1500
White Bear Lake, MN 55110
Phone (651) 493-8150

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": "1259625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1366770406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 WHITE BEAR PKWY STE 1500",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103697",
            "telephone_number": "651-493-8150",
            "fax_number": "651-493-9335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 WHITE BEAR PKWY STE 1500",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "55110",
            "telephone_number": "651-493-8150",
            "fax_number": "651-493-9335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3640 Talmage Circle",
            "address_2": "Suite 210",
            "address_purpose": "LOCATION",
            "city": "Vadnais Heights",
            "state": "MN",
            "postal_code": "551107100",
            "country_code": "US",
            "telephone_number": "651-470-4671",
            "fax_number": "612-437-4971",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOVEY",
        "first_name": "DIANE",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-01",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1967",
            "primary": true
        },
        {
            "code": "102X00000X",
            "taxonomy_group": "",
            "desc": "Poetry Therapist",
            "state": null,
            "license": "C2007-105",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366770406",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Bear Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; 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.