Individual provider Active NPI

Marissa Emily Marx, LPCC

  • Mental Health Counselor
  • Coon Rapids, MN
National Provider Identifier
1649783770
Registry record updated Nov 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1651 Issued in MN
Practice address
9120 Springbrook Dr NW
Coon Rapids, MN 55433-5845
Phone
(763) 231-2590
NPI assigned
Nov 11, 2017
Last updated
Nov 11, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1651 MN Primary

Addresses

Primary practice location

9120 Springbrook Dr NW
Coon Rapids, MN 55433-5845

Mailing address

9120 Springbrook Dr NW
Coon Rapids, MN 55433-5845
Phone (763) 231-2590

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
I20250616001504 MN Practitioner - Mental Health Counselor 4385168392 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Conscious Healing Counseling IncGroup PAC ID 4688095268, 16 clinicians

Practice addresses (Care Compare)

2705 Bunker Lake Blvd NW
Suite 112
Andover, MN 55304-3785
Phone (612) 900-0233

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1651MNMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Conscious Healing Counseling Inc Mental Health CurrentSince Jun 9, 2025 Accepting new patients
Fraser Past Accepting new patients
Fraser Child and Family Center PastSince Sep 15, 2023 Accepting new patients

Locations

2705 Bunker Lake Blvd NW
Ste 112
Andover, MN 55304
Phone (612) 900-0233

Organizations & group practices 4

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": "1510358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510358400000",
    "number": "1649783770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9120 SPRINGBROOK DR NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335845",
            "telephone_number": "763-231-2590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9120 SPRINGBROOK DR NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335845",
            "telephone_number": "763-231-2590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARX",
        "first_name": "MARISSA",
        "middle_name": "EMILY",
        "name_prefix": "Mrs.",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-11",
        "last_updated": "2017-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "1651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.