Individual provider Active NPI

Tammy S McCarthy, MA, LMFT

  • Marriage & Family Therapist
  • Eden Prairie, MN
National Provider Identifier
1629400833
Registry record updated Mar 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2715 Issued in MN
Practice address
11010 Prairie Lakes Dr Ste 350
Eden Prairie, MN 55344-3801
Phone
(952) 746-2522
Fax
(952) 746-0887
NPI assigned
Jul 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2018

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 2715 MN Primary

Addresses

Primary practice location

11010 Prairie Lakes Dr Ste 350
Eden Prairie, MN 55344-3801

Mailing address

1900 Silver Lake Rd NW
Suite 115
New Brighton, MN 55112-1786
Phone (651) 628-9566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240222000833 MN Practitioner - Marriage and Family Therapist 9032553698

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Family Support Services Inc. PastSince Oct 10, 2009 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": "1375142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522108800000",
    "number": "1629400833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW",
            "address_2": "SUITE 115",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121786",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11010 PRAIRIE LAKES DR STE 350",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443801",
            "telephone_number": "952-746-2522",
            "fax_number": "952-746-0887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "TAMMY",
        "middle_name": "S",
        "credential": "MA, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-30",
        "last_updated": "2018-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

Verify at the official NPI Registry.