Mark R Thelen, PSYD LP LMFT

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP2992 Issued in MN

Practice address

261 E Broadway St
Monticello, MN 55362-9317

Phone

(763) 370-0243

NPI assigned

Apr 7, 2006

Last updated

Apr 21, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Thelen Therapy Services LLC

  • Community/Behavioral Health Agency
  • Monticello, MN
  • NPI 1649937996
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1568425908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553620102",
            "telephone_number": "763-370-0243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 E BROADWAY ST",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553629317",
            "telephone_number": "763-370-0243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THELEN",
        "first_name": "MARK",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PSYD LP LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "645",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP2992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tareen Dermatology, PA
• Henry Yarkpawolo Tarnue, PHARM. D
• Team Chiropractic & Wellness Center
• Kristin Mary Theisen, RPH
• Thelen Therapy Services LLC
• Tollefson Counseling Services
• Barbara Jean Tollefson, MA LP
• Mark S. Tonn, DC
• Joanna Rose Tran, DDS
• Tranquil Minda Mental Health LLC (Tranquil Minds Mental Health)

• Psychologist in Monticello, MN
• Providers in Monticello, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.