Individual provider Active NPI

Maureen Ann Daugherty, MA

  • Marriage & Family Therapist
  • Coon Rapids, MN
National Provider Identifier
1649559378
Registry record updated Aug 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
3361 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2624
Phone
(612) 644-6373
NPI assigned
Aug 11, 2011
Last updated
Aug 12, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2011

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 MN Primary

Addresses

Primary practice location

3361 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2624

Mailing address

3361 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2624
Phone (612) 644-6373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • 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
I20240416001299 MN Practitioner - Marriage and Family Therapist 7911346523 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Brain and Body Clinic PLLC CurrentSince Mar 5, 2024 Accepting new patients
Danielle Golden, Crna, PA CurrentSince Jul 1, 2025 Accepting new patients

Locations

701 Decatur Ave N
Ste 109
Minneapolis, MN 55427
Phone (763) 746-2400

13911 Ridgedale Dr
Ste 110
Minnetonka, MN 55305
Phone (605) 348-8000

3555 Willow Lake Blvd
Ste 290
Vadnais Heights, MN 55110

3640 Talmage Cir
Ste 216
Vadnais Hts, MN 55110
Phone (651) 379-4006

636 Saint Anne St
Rapid City, SD 57701
Phone (605) 348-8000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1313020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313107200000",
    "number": "1649559378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3361 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332624",
            "telephone_number": "612-644-6373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3361 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332624",
            "telephone_number": "612-644-6373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHERTY",
        "first_name": "MAUREEN",
        "middle_name": "ANN",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-11",
        "last_updated": "2011-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.