Individual provider Active NPI

Tina Saunders, MA, LMFT

  • Marriage & Family Therapist
  • St Louis Park, MN
National Provider Identifier
1396133013
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
3022 Issued in MN
Practice address
6465 Wayzata Blvd Ste 710
St Louis Park, MN 55426-1733
Phone
(612) 269-0168
NPI assigned
Jan 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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 3022 MN Primary

Addresses

Primary practice location

6465 Wayzata Blvd Ste 710
St Louis Park, MN 55426-1733

Mailing address

12415 53Rd Ave N
Plymouth, MN 55442-2050
Phone (612) 269-0168

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
I20240709001807 MN Practitioner - Marriage and Family Therapist 0648715144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West End Therapy Clinic LLCGroup PAC ID 7113361916, 9 clinicians

Practice addresses (Care Compare)

6465 Wayzata Blvd
Suite 710
St Louis Park, MN 55426-1733
Phone (651) 353-5007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3022MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
West End Therapy Clinic LLC Marriage & Family Therapist CurrentSince Apr 26, 2024 Accepting new patients

Locations

6465 Wayzata Blvd
Ste 710
St Louis Park, MN 55426
Phone (612) 735-8002

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": "1420416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1396133013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12415 53RD AVE N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554422050",
            "telephone_number": "612-269-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6465 WAYZATA BLVD STE 710",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554261733",
            "telephone_number": "612-269-0168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUNDERS",
        "first_name": "TINA",
        "credential": "MA, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-05",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.