Morgan Brumbaugh

Individual provider Active NPI Marriage & Family Therapist · Rogers, MN

NPI 1598166100 · NPPES record last updated Jul 7, 2021

Key facts

NPI
1598166100
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
3303 (MN)
Practice address
14000 Northdale Blvd Ste I
Rogers, MN 55374-4663
Phone
(763) 575-8086
NPI assigned
Sep 15, 2014
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
3303MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Vanda Counseling and Psychological Services Current
since Jul 17, 2021
Accepting new patients
Lorenz Clinic, LLC Marriage & Family Therapist Past
since Jun 7, 2016
Accepting new patients

Locations

14000 Northdale Blvd
Ste I
Rogers, MN 55374
Phone (763) 575-8086

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16506/brand/1/csg/1/fhir/r4

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Marriage & Family Therapist 106H00000X 3303 MN Yes

Addresses

Primary practice location

14000 Northdale Blvd Ste I
Rogers, MN 55374-4663

Mailing address

14000 Northdale Blvd Ste I
Rogers, MN 55374-4663
Phone (637) 575-8086

Other names

  • Morgan Lacey Former name

Other providers in Rogers, MN

All providers in Rogers, MN · Marriage & Family Therapist in Minnesota

Sources for this page

Verify at the official NPI Registry.