Individual provider Active NPI

Rebecca Ann Krenz, LMFT

  • Marriage & Family Therapist
  • Golden Valley, MN
National Provider Identifier
1629363395
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
3974 Issued in MN
Practice address
8085 Wayzata Blvd Ste 215
Golden Valley, MN 55426-1457
Phone
(612) 351-0427
Fax
(651) 493-2798
NPI assigned
Jun 10, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X
Marriage & Family Therapist 106H00000X 904-124 WI
Marriage & Family Therapist 106H00000X 3974 MN Primary

Addresses

Primary practice location

8085 Wayzata Blvd Ste 215
Golden Valley, MN 55426-1457

Mailing address

8085 Wayzata Blvd Ste 215
Minneapolis, MN 55426-1457
Phone (612) 351-0427

Other practice location 1

3015 N 114th St
Wauwatosa, WI 53222-4208
Phone (414) 431-4444

Other practice location 2

620 S 76th St
Milwaukee, WI 53214-1599
Phone (414) 453-1400

Other identifiers 1

IdentifierTypeStateIssuer
1629363395MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 17, 2024 through Jan 17, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3974MNMDMental Health Counselor
904-124WIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Intuitive Therapy & Consulting, LLC Marriage & Family Therapist PastSince Jan 19, 2020 Accepting new patients

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": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1629363395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8085 WAYZATA BLVD STE 215",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554261457",
            "telephone_number": "612-351-0427",
            "fax_number": "651-493-2798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8085 WAYZATA BLVD STE 215",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554261457",
            "telephone_number": "612-351-0427",
            "fax_number": "651-493-2798"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3015 N 114th St",
            "address_purpose": "LOCATION",
            "city": "Wauwatosa",
            "state": "WI",
            "postal_code": "532224208",
            "country_code": "US",
            "telephone_number": "414-431-4444",
            "fax_number": "414-431-0858",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "620 S 76th St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532141599",
            "country_code": "US",
            "telephone_number": "414-453-1400",
            "fax_number": "414-453-2538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRENZ",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-10",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "904-124",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629363395",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

Verify at the official NPI Registry.