Individual provider Active NPI

Elisha Ann Engelen, LMFT

  • Marriage & Family Therapist
  • Chaska, MN
National Provider Identifier
1548424096
Registry record updated Apr 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1641 Issued in MN
Practice address
112 E 5TH St
#202
Chaska, MN 55318-2251
Phone
(952) 448-7052
Fax
(952) 448-7029
NPI assigned
Jul 14, 2008
Last updated
Apr 25, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2011

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 1641 MN Primary

Addresses

Primary practice location

112 E 5TH St
#202
Chaska, MN 55318-2251

Mailing address

112 E 5TH St
#202
Chaska, MN 55318-2251
Phone (952) 448-7052

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
1641MNMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Family Therapy Specialists, Inc Marriage & Family Therapist Past Accepting new patients

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": "1215993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303689600000",
    "number": "1548424096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 E 5TH ST",
            "address_2": "#202",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553182251",
            "telephone_number": "952-448-7052",
            "fax_number": "952-448-7029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 E 5TH ST",
            "address_2": "#202",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553182251",
            "telephone_number": "952-448-7052",
            "fax_number": "952-448-7029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGELEN",
        "first_name": "ELISHA",
        "middle_name": "ANN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-14",
        "last_updated": "2011-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chaska, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2011; 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.