Individual provider Active NPI

Christie Marie Haustein, LMFT

  • Marriage & Family Therapist
  • Brooklyn Center, MN
National Provider Identifier
1417215153
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2116 Issued in MN
Practice address
5910 Shingle Creek Pkwy
Brooklyn Center, MN 55430-2322
Phone
(763) 569-5200
Fax
(763) 569-5201
NPI assigned
May 1, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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 2116 MN Primary

Addresses

Primary practice location

5910 Shingle Creek Pkwy
Brooklyn Center, MN 55430-2322

Mailing address

5910 Shingle Creek Pkwy
Brooklyn Center, MN 55430-2322
Phone (763) 569-5201

Other practice location 1

6425 Nicollet Ave
Richfield, MN 55423-1675
Phone (612) 861-1675

Other identifiers 1

IdentifierTypeStateIssuer
875055600MedicaidMN

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

State licenses

LicenseStateTypeSpecialty
2116MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Youable Emotional Health Services CurrentSince Jan 5, 2023 Accepting new patients

Locations

5910 Shingle Creek Pkwy
Minneapolis, MN 55430
Phone (763) 569-5200

701 Decatur Ave N
Ste 109
Minneapolis, MN 55427
Phone (763) 746-2400

6425 Nicollet Ave
Richfield, MN 55423
Phone (612) 861-1675

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": "1335830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1417215153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5910 SHINGLE CREEK PKWY",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302322",
            "telephone_number": "763-569-5201",
            "fax_number": "763-569-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5910 SHINGLE CREEK PKWY",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302322",
            "telephone_number": "763-569-5200",
            "fax_number": "763-569-5201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6425 Nicollet Ave",
            "address_purpose": "LOCATION",
            "city": "Richfield",
            "state": "MN",
            "postal_code": "554231675",
            "country_code": "US",
            "telephone_number": "612-861-1675",
            "fax_number": "612-861-3446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAUSTEIN",
        "first_name": "CHRISTIE",
        "middle_name": "MARIE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-01",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "875055600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn Center, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; 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.