Individual provider Active NPI

Yaneth Annette Cunningham, LMFT

  • Marriage & Family Therapist
  • Bloomington, MN
National Provider Identifier
1417516931
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
3693 Issued in MN
Practice address
8120 Penn Ave S Ste 270
Bloomington, MN 55431-1320
Phone
(800) 336-5973
Fax
(612) 234-4689
NPI assigned
Jun 8, 2019
Last updated
Dec 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 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 TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X 3693 MN Primary

Addresses

Primary practice location

8120 Penn Ave S Ste 270
Bloomington, MN 55431-1320

Mailing address

8120 Penn Ave S Ste 270
Bloomington, MN 55431-1320
Phone (800) 336-5973

Other practice location 1

8350 Aldrich Ave S
Bloomington, MN 55420-2259
Phone (952) 334-4675

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
I20240219003007 MN Practitioner - Marriage and Family Therapist 3779927645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catalyst Mental Health, GBCGroup PAC ID 1355500752, 29 clinicians

Practice addresses (Care Compare)

8120 Penn Ave S
Suite 270
Bloomington, MN 55431-1320
Phone (800) 336-5973

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3693MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Catalyst Mental Health, GBC Single Specialty CurrentSince Jan 1, 2024 Accepting new patients
Catalyst Mental Health, GBC Single Specialty CurrentSince Jan 1, 2024 Accepting new patients
Eden Therapy Center, LLC Single Specialty PastSince Apr 18, 2022 Accepting new patients

Locations

1915 Lyndale Ave S
Minneapolis, MN 55403
Phone (800) 336-5973

8120 Penn Ave S
Ste 270
Minneapolis, MN 55431
Phone (800) 336-5973

Organizations & group practices 3

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": "1559952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1417516931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8120 PENN AVE S STE 270",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554311320",
            "telephone_number": "800-336-5973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8120 PENN AVE S STE 270",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554311320",
            "telephone_number": "800-336-5973",
            "fax_number": "612-234-4689"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8350 Aldrich Ave S",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "MN",
            "postal_code": "554202259",
            "country_code": "US",
            "telephone_number": "952-334-4675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "YANETH",
        "middle_name": "ANNETTE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-08",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.