Individual provider Active NPI

Daniel Braden Redman

  • Marriage & Family Therapist
  • Eagan, MN
National Provider Identifier
1669962510
Registry record updated Sep 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
3301 Issued in MN
Practice address
3450 Oleary LN
Eagan, MN 55123-2340
Phone
(651) 365-8253
Fax
(952) 435-0599
NPI assigned
May 16, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 3301 MN Primary
Marriage & Family Therapist 106H00000X

Addresses

Primary practice location

3450 Oleary LN
Eagan, MN 55123-2340

Mailing address

3450 Oleary LN
Eagan, MN 55123-2340
Phone (651) 365-8253

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
I20240116001184 MN Practitioner - Marriage and Family Therapist 6800274200 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eagan Counseling ClinicGroup PAC ID 2860304045, 62 clinicians

Practice addresses (Care Compare)

18586 Joplin Ave
Lakeville, MN 55044-4218
Phone (952) 435-8700

3450 Oleary LN
Eagan, MN 55123-2340
Phone (651) 454-0114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3301MNMDProfessional Counselor

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": "1526428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538006400000",
    "number": "1669962510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 OLEARY LN",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551232340",
            "telephone_number": "651-365-8253",
            "fax_number": "952-435-0599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 OLEARY LN",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551232340",
            "telephone_number": "651-365-8253",
            "fax_number": "952-435-0599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDMAN",
        "first_name": "DANIEL",
        "middle_name": "BRADEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-16",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3301",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.