Individual provider Active NPI

Michelle Ann Craveiro, MA, LMFT

  • Marriage & Family Therapist
  • Saint Paul, MN
National Provider Identifier
1497755409
Registry record updated Dec 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT1023 Issued in MN
Practice address
1684 Selby Ave
Saint Paul, MN 55104
Phone
(952) 222-0399
Fax
(612) 374-4498
NPI assigned
Aug 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2018

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 1023 MN
Marriage & Family Therapist 106H00000X LMFT1023 MN Primary

Addresses

Primary practice location

1684 Selby Ave
Saint Paul, MN 55104

Mailing address

1660 Hwy 100 South
Suite 330
Saint Louis Park, MN 55416
Phone (952) 224-0399

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
I20240229003150 MN Practitioner - Marriage and Family Therapist 5193160117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2000
Medicare assignment
May accept Medicare assignment
Group practices
Parkdale Therapy Group, LLCGroup PAC ID 8921355496, 3 clinicians

Practice addresses (Care Compare)

1000 Shelard Pkwy
Suite 520
Saint Louis Park, MN 55426-4932
Phone (952) 224-0399

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LMFT1023MNMDMarriage & Family Therapist
1023MNMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Parkdale Therapy Group, LLC Marriage & Family Therapist CurrentSince Jan 16, 2024 Accepting new patients

Locations

1684 Selby Ave
Saint Paul, MN 55104
Phone (651) 206-8955

1660 Highway 100 S
Ste 330
St Louis Park, MN 55416
Phone (651) 621-0688

1000 Shelard Pkwy
Ste 520
St Louis Park, MN 55426
Phone (952) 224-0399

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": "1122854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544054400000",
    "number": "1497755409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 HWY 100 SOUTH",
            "address_2": "SUITE 330",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "55416",
            "telephone_number": "952-224-0399",
            "fax_number": "612-374-4498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1684 SELBY AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55104",
            "telephone_number": "952-222-0399",
            "fax_number": "612-374-4498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAVEIRO",
        "first_name": "MICHELLE",
        "middle_name": "ANN",
        "credential": "MA, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-01",
        "last_updated": "2018-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1023",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "LMFT1023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.