Individual provider Active NPI

Ann E. Markovich, MA., LMFT, DBT CERTI

  • Marriage & Family Therapist
  • Brooklyn Park, MN
National Provider Identifier
1578813010
Registry record updated Jul 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2044 Issued in MN
Practice address
Prairiecare
9400 Zane Ave N
Brooklyn Park, MN 55443-1814
Phone
(763) 762-8800
NPI assigned
Sep 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2021

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 2044 MN Primary

Addresses

Primary practice location

Prairiecare
9400 Zane Ave N
Brooklyn Park, MN 55443-1814

Mailing address

5528 Holiday Rd
Minnetonka, MN 55345-5414
Phone (651) 334-5157

Other practice location 1

5528 Holiday Rd
Minnetonka, MN 55345-5414
Phone (652) 373-9308

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
I20240329001386 MN Practitioner - Marriage and Family Therapist 8325486160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Croix Psychiatric LLCGroup PAC ID 9335288786, 45 clinicians

Practice addresses (Care Compare)

9400 Zane Ave N
Brooklyn Park, MN 55443-1814
Phone (952) 826-8475

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Croix Psychiatric, LLC Marriage & Family Therapist CurrentSince Jan 1, 2024 Accepting new patients

Locations

9400 Zane Ave N
Minneapolis, MN 55443
Phone (763) 383-5800

4510 77th St W
Minneapolis, MN 55435
Phone (952) 230-9100

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": "1347408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1578813010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5528 HOLIDAY RD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553455414",
            "telephone_number": "651-334-5157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PRAIRIECARE",
            "address_2": "9400 ZANE AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431814",
            "telephone_number": "763-762-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5528 Holiday Rd",
            "address_purpose": "LOCATION",
            "city": "Minnetonka",
            "state": "MN",
            "postal_code": "553455414",
            "country_code": "US",
            "telephone_number": "652-373-9308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARKOVICH",
        "first_name": "ANN",
        "middle_name": "E.",
        "name_prefix": "Ms.",
        "credential": "MA., LMFT, DBT CERTI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-12",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn Park, MN

Sources for this page

Verify at the official NPI Registry.