Individual provider Active NPI

Christine Broughten, MA, LMFT

  • Marriage & Family Therapist
  • Minneapolis, MN
National Provider Identifier
1619366044
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2760 Issued in MN
Practice address
621 W Lake St Ste 350
Minneapolis, MN 55408-2952
Phone
(612) 547-9990
NPI assigned
Jan 22, 2015
Last updated
Mar 19, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2019

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 2760 MN Primary

Addresses

Primary practice location

621 W Lake St Ste 350
Minneapolis, MN 55408-2952

Mailing address

4317 12TH Ave S
Minneapolis, MN 55407-3217
Phone (507) 649-0714

Other names 1

  • Christine Keller Former name

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
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1619366044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4317 12TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073217",
            "telephone_number": "507-649-0714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 W LAKE ST STE 350",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082952",
            "telephone_number": "612-547-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUGHTEN",
        "first_name": "CHRISTINE",
        "credential": "MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-22",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "KELLER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2019; 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.