Alyssum Meryl Anderson, LMFT
Individual provider Active NPI Marriage & Family Therapist · Saint Paul, MN
NPI 1598445256 · NPPES record last updated Jul 18, 2023
Key facts
- NPI
- 1598445256
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 4034 (MN)
- Practice address
- 1114 Grand Ave
Saint Paul, MN 55105-2628 - Phone
- (651) 829-3568
- NPI assigned
- Jul 18, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240329000912 | MN | Practitioner - Marriage and Family Therapist | 3971941709 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4034 | MN | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Down to Earth Therapy LLC | Marriage & Family Therapist | Current |
Accepting new patients |
Locations
1114 Grand Ave
Saint Paul, MN 55105
Phone (612) 284-1848
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 4034 | MN | Yes |
Addresses
Primary practice location
1114 Grand Ave
Saint Paul, MN 55105-2628
Mailing address
1133 Idaho Ave W
Saint Paul, MN 55108-2232
Phone (612) 298-4601
Other providers in Saint Paul, MN
- Kahmiyah Anderson-Lamar
- Abigail Lynn Anderson
- Alaina Anderson
- Alicia Marie Anderson
- Alyssa Marie Anderson
- Andrea Elizabeth Anderson
- Angela Joyce Anderson
- Anthony Wyatt Anderson
- Bethel Anderson
- Britney S Anderson
All providers in Saint Paul, MN · Marriage & Family Therapist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.