Active NPI
Kay Lynn Manahan, LMFT
- Marriage & Family Therapist
- Eagan, MN
National Provider Identifier
1558083212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 3323
- Practice address
- 4555 Erin Dr Ste 200
Eagan, MN 55122-3432 - Phone
- (952) 894-7722
- Fax
- (952) 894-0882
- NPI assigned
- Sep 19, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 3323 | MN | Primary |
Addresses
Primary practice location
4555 Erin Dr Ste 200
Eagan, MN 55122-3432
Mailing address
615 W Travelers TRL
Burnsville, MN 55337-2553
Phone (952) 894-7722
Other practice location 1
7170 Bryant Lake Dr
Eden Prairie, MN 55344-3502
Phone (952) 894-7722
Other practice location 2
16005 Joplin Ave
Lakeville, MN 55044-9483
Phone (952) 894-7722
Other practice location 3
4205 Lancaster Ln N Ste 101
Plymouth, MN 55441-1702
Phone (952) 894-7722
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 8, 2024 through Jan 8, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663545600000",
"number": "1558083212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 W TRAVELERS TRL",
"city": "BURNSVILLE",
"state": "MN",
"postal_code": "553372553",
"telephone_number": "952-894-7722",
"fax_number": "952-894-0882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4555 ERIN DR STE 200",
"city": "EAGAN",
"state": "MN",
"postal_code": "551223432",
"telephone_number": "952-894-7722",
"fax_number": "952-894-0882"
}
],
"practiceLocations": [
{
"address_1": "7170 Bryant Lake Dr",
"address_purpose": "LOCATION",
"city": "Eden Prairie",
"state": "MN",
"postal_code": "553443502",
"country_code": "US",
"telephone_number": "952-894-7722",
"fax_number": "952-894-0882",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "16005 Joplin Ave",
"address_purpose": "LOCATION",
"city": "Lakeville",
"state": "MN",
"postal_code": "550449483",
"country_code": "US",
"telephone_number": "952-894-7722",
"fax_number": "952-894-0882",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4205 Lancaster Ln N Ste 101",
"address_purpose": "LOCATION",
"city": "Plymouth",
"state": "MN",
"postal_code": "554411702",
"country_code": "US",
"telephone_number": "952-894-7722",
"fax_number": "952-894-0882",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MANAHAN",
"first_name": "KAY",
"middle_name": "LYNN",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-19",
"last_updated": "2022-09-19",
"certification_date": "2021-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "3323",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eagan, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.