Individual provider Active NPI

Nancy Jean Dorman, LAMFT

  • Marriage & Family Therapist
  • Saint Paul, MN
National Provider Identifier
1447594221
Registry record updated Nov 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2502 Issued in MN
Practice address
4501 Allendale Dr
Saint Paul, MN 55127-6349
Phone
(651) 653-0387
NPI assigned
Nov 19, 2012
Last updated
Nov 19, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2012

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 2502 MN Primary

Addresses

Primary practice location

4501 Allendale Dr
Saint Paul, MN 55127-6349

Mailing address

4501 Allendale Dr
Saint Paul, MN 55127-6349
Phone (651) 653-0387

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
I20231218003868 MN Practitioner - Marriage and Family Therapist 0446600332 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
Telehealth
Offers telehealth services
Group practices
Beacon Therapy Associates PCGroup PAC ID 4284887472, 6 clinicians

Practice addresses (Care Compare)

11141 Zealand Ave N
Champlin, MN 55316-3595
Phone (763) 951-3091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Therapy Associates, PC Marriage & Family Therapist CurrentSince Jan 1, 2024 Accepting new patients

Locations

11141 Zealand Ave N
Champlin, MN 55316
Phone (651) 653-0387

4501 Allendale Dr
Saint Paul, MN 55127
Phone (651) 653-0387

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": "1353283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353283200000",
    "number": "1447594221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 ALLENDALE DR",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551276349",
            "telephone_number": "651-653-0387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 ALLENDALE DR",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551276349",
            "telephone_number": "651-653-0387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORMAN",
        "first_name": "NANCY",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "LAMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-19",
        "last_updated": "2012-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.