Individual provider Active NPI

Nicole Casey, LMFT

  • Marriage & Family Therapist
  • Golden Valley, MN
National Provider Identifier
1376098715
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2964 Issued in MN
Practice address
4959 Olson Memorial Hwy Ste B
Golden Valley, MN 55422-5159
Phone
(612) 242-6338
NPI assigned
Aug 15, 2016
Last updated
Oct 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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 2964 MN Primary

Addresses

Primary practice location

4959 Olson Memorial Hwy Ste B
Golden Valley, MN 55422-5159

Mailing address

101 Westwood Dr N
Golden Valley, MN 55422-5258
Phone (612) 242-6338

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
I20250609002962 MN Practitioner - Marriage and Family Therapist 1951811934 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2964MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lyn-Lake Psychotherapy and Wellness LTD. CurrentSince Apr 4, 2025 Accepting new patients
Soul Centered Therapy, LLC CurrentSince Nov 8, 2025 Accepting new patients

Locations

2900 Thomas Ave S
Ste 100
Minneapolis, MN 55416

4959 Olson Memorial Hwy
Ste B
Minneapolis, MN 55422
Phone (612) 205-9745

621 W Lake St
Ste 350
Minneapolis, MN 55408
Phone (612) 547-9990

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1471219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1376098715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 WESTWOOD DR N",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554225258",
            "telephone_number": "612-242-6338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4959 OLSON MEMORIAL HWY STE B",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554225159",
            "telephone_number": "612-242-6338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASEY",
        "first_name": "NICOLE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-15",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

Verify at the official NPI Registry.