Individual provider Active NPI

Luke A Knutson, LMFT

  • Marriage & Family Therapist
  • Saint Paul, MN
National Provider Identifier
1376759464
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1314 Issued in MN
Practice address
1711 Juliet Ave
Saint Paul, MN 55105-2122
Phone
(651) 695-1620
NPI assigned
May 15, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1314 MN Primary

Addresses

Primary practice location

1711 Juliet Ave
Saint Paul, MN 55105-2122

Mailing address

1711 Juliet Ave
Saint Paul, MN 55105-2122
Phone (651) 695-1620

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
I20231218004118 MN Practitioner - Marriage and Family Therapist 4082069620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovative Psychological Consultants, LLCGroup PAC ID 3678596285, 15 clinicians

Practice addresses (Care Compare)

7236 Forestview LN N
Maple Grove, MN 55369-5656
Phone (763) 416-4167

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1314MNMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Knutson Counseling Clinic Current Accepting new patients
Innovative Psychological Consultants, LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

7236 Forestview Ln N
Maple Grove, MN 55369
Phone (763) 416-4167

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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376759464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 JULIET AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052122",
            "telephone_number": "651-695-1620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 JULIET AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052122",
            "telephone_number": "651-695-1620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUTSON",
        "first_name": "LUKE",
        "middle_name": "A",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.