Amy Boldt, LMFT
Individual provider Active NPI Marriage & Family Therapist · Milaca, MN
NPI 1669840948 · NPPES record last updated Oct 12, 2023
Key facts
- NPI
- 1669840948
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 3032 (MN)
- Practice address
- 150 10TH St NW Ste 2
Milaca, MN 56353-1737 - Phone
- (320) 983-2335
- Fax
- (651) 342-8029
- NPI assigned
- Sep 3, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Marriage and Family Therapist
- Education
- Other, 2012
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
- Lighthouse Child and Family Services
Fernbrook Family Center Inc
Practice addresses (Care Compare)
150 10TH St NW
Suite 2
Milaca, MN 56353-1737
Phone (320) 983-2335
2575 Harvest LN
Owatonna, MN 55060-4305
Phone (507) 446-0431
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240216002695 | MN | Practitioner - Marriage and Family Therapist | 4981048014 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fernbrook Family Center, Inc | Current |
Accepting new patients | |
| Lighthouse Child & Family Services | Current |
Accepting new patients | |
| Awakened Connections Therapy | Past |
Accepting new patients |
Locations
340 Garfield St S
Cambridge, MN 55008
Phone (320) 982-0035
150 10th St NW
#2
Milaca, MN 56353
Phone (320) 249-3183
2575 Harvest Ln
Owatonna, MN 55060
Phone 5074460431115
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 3032 | MN | Yes |
Addresses
Primary practice location
150 10TH St NW Ste 2
Milaca, MN 56353-1737
Mailing address
150 10TH St NW Ste 2
Milaca, MN 56353-1737
Phone (320) 983-2335
Other providers in Milaca, MN
- Awakened Connections Therapy
- Ahnnica Jane Lambrides Baade
- Brianna Lynn Beise
- Brittany Ann Bemboom
- Kari Lee Bergeron
- Borowicz Dental PLLC
- Lisa Braith
- Heather Amanda Rose Brooks
- Douglas Donald Bye
- C Johnson Inc
All providers in Milaca, MN · Marriage & Family Therapist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 12, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.