Individual provider Active NPI

Emily Heitman, LMFT

  • Marriage & Family Therapist
  • Fridley, MN
National Provider Identifier
1609400134
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
3635 Issued in MN
Practice address
5155 E River Rd Ste 401
Fridley, MN 55421-3777
Phone
(763) 780-3307
Fax
(763) 780-3306
NPI assigned
Feb 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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 3635 MN Primary

Addresses

Primary practice location

5155 E River Rd Ste 401
Fridley, MN 55421-3777

Mailing address

5155 E River Rd Ste 401
Fridley, MN 55421-3777
Phone (763) 780-3307

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3635MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Psychological Services Inc CurrentSince Mar 1, 2020 Accepting new patients
Lighthouse Psychological Services, Inc. PastSince Mar 1, 2020 Accepting new patients

Locations

5155 E River Rd
Ste 401
Minneapolis, MN 55421
Phone (763) 438-4038

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.

NPI Registry JSON

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

{
    "created_epoch": "1582502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1609400134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5155 E RIVER RD STE 401",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554213777",
            "telephone_number": "763-780-3307",
            "fax_number": "763-780-3306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5155 E RIVER RD STE 401",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554213777",
            "telephone_number": "763-780-3307",
            "fax_number": "763-780-3306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEITMAN",
        "first_name": "EMILY",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-24",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fridley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.