Individual provider Active NPI

Lewis Paige Sego II, MA LMFT

  • Marriage & Family Therapist
  • Buffalo, MN
National Provider Identifier
1437898160
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
3839 Issued in MN
Practice address
102 Marty Dr Ste 2
Buffalo, MN 55313-9345
Phone
(763) 682-5420
NPI assigned
Jun 1, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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 3839 MN Primary

Addresses

Primary practice location

102 Marty Dr Ste 2
Buffalo, MN 55313-9345

Mailing address

102 Marty Dr Ste 2
Buffalo, MN 55313-9345
Phone (763) 682-5420

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
I20240319000881 MN Practitioner - Marriage and Family Therapist 1658718259 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
Family Counseling Center IncGroup PAC ID 6204732613, 2 clinicians

Practice addresses (Care Compare)

102 Marty Dr
Buffalo, MN 55313-9305
Phone (763) 682-5420

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3839MNMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Counseling Center Inc CurrentSince Mar 5, 2024 Accepting new patients

Locations

102 Marty Dr
Ste 2
Buffalo, MN 55313
Phone (763) 682-5420

102 Marty Dr
Buffalo, MN 55313
Phone (763) 682-5420

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, 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": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1437898160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 MARTY DR STE 2",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553139345",
            "telephone_number": "763-682-5420",
            "fax_number": "763-682-5413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 MARTY DR STE 2",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553139345",
            "telephone_number": "763-682-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGO",
        "first_name": "LEWIS",
        "middle_name": "PAIGE",
        "name_suffix": "II",
        "credential": "MA LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-01",
        "last_updated": "2022-06-01",
        "certification_date": "2022-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, MN

Sources for this page

Verify at the official NPI Registry.