Individual provider Active NPI

Heather Marie O'Connor, LMFT, LADC

  • Marriage & Family Therapist
  • Savage, MN
National Provider Identifier
1407025455
Registry record updated Aug 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2505 Issued in MN
Practice address
8640 Eagle Creek Circle
Savage, MN 55378
Phone
(952) 746-7664
Fax
(952) 746-0582
NPI assigned
Feb 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2014

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 2505 MN Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 301795 MN

Addresses

Primary practice location

8640 Eagle Creek Circle
Savage, MN 55378

Mailing address

8640 Eagle Creek Circle
Savage, MN 55378
Phone (952) 746-7664

Other identifiers 1

IdentifierTypeStateIssuer
301795OtherMNLADC

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
I20240118003187 MN Practitioner - Marriage and Family Therapist 1658723291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
River Valley Behavioral Health and Wellness Center, PLLCGroup PAC ID 3678625035, 17 clinicians

Practice addresses (Care Compare)

8640 Eagle Creek Cir
Savage, MN 55378-4400
Phone (952) 746-7664

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
301795MNMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
River Valley Behavioral Health & Wellness Center, PLLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

8640 Eagle Creek Cir
Savage, MN 55378
Phone (952) 746-7664

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": "1203897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407283200000",
    "number": "1407025455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8640 EAGLE CREEK CIRCLE",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "55378",
            "telephone_number": "952-746-7664",
            "fax_number": "952-746-0582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8640 EAGLE CREEK CIRCLE",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "55378",
            "telephone_number": "952-746-7664",
            "fax_number": "952-746-0582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "HEATHER",
        "middle_name": "MARIE",
        "credential": "LMFT, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-25",
        "last_updated": "2014-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2505",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "301795",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LADC",
            "identifier": "301795",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savage, MN

Sources for this page

Verify at the official NPI Registry.