Active NPI
Nicholas Prakash Newstrom, LMFT
- Marriage & Family Therapist
- Minnetonka, MN
National Provider Identifier
1689013336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 2389
- Practice address
- 17717 Highway 7
Minnetonka, MN 55345-4148 - Phone
- (952) 936-0304
- Fax
- (952) 936-0454
- NPI assigned
- Jun 17, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 2389 | MN | Primary |
Addresses
Primary practice location
17717 Highway 7
Minnetonka, MN 55345-4148
Mailing address
18141 Fresno St NW
Elk River, MN 55330-1714
Phone (763) 370-8619
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2389 | MN | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371427200000",
"number": "1689013336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18141 FRESNO ST NW",
"city": "ELK RIVER",
"state": "MN",
"postal_code": "553301714",
"telephone_number": "763-370-8619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17717 HIGHWAY 7",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553454148",
"telephone_number": "952-936-0304",
"fax_number": "952-936-0454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEWSTROM",
"first_name": "NICHOLAS",
"middle_name": "PRAKASH",
"name_prefix": "Mr.",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-06-17",
"last_updated": "2013-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "2389",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minnetonka, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.