Mary Clark, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

3298 Issued in MN

Practice address

2232 2ND Ave E Ste 5
International Falls, MN 56649-4042

Phone

(218) 319-7171

Fax

(218) 260-4749

NPI assigned

Aug 22, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Cedar Branch Counseling Group, PLLC

  • Marriage & Family Therapist
  • International Falls, MN
  • NPI 1912497348
  NPD Authorized official

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

{
    "created_epoch": "1471824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1689129546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2232 2ND AVE E STE 5",
            "city": "INTERNATIONAL FALLS",
            "state": "MN",
            "postal_code": "566494042",
            "telephone_number": "218-319-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2232 2ND AVE E STE 5",
            "city": "INTERNATIONAL FALLS",
            "state": "MN",
            "postal_code": "566494042",
            "telephone_number": "218-319-7171",
            "fax_number": "218-260-4749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MARY",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-22",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Dennis Christianson, L.A.D.C.
• Bruce A Christopherson
• City Cab & Van Service, Inc.
• City of International Falls
• Alyssa Louann Clarity, DC
• Jessica Marie Cobban, PA-C
• Corrin Dental PLLC
• County of Koochiching
• Dean Christopher Cowman, DC
• Samantha Ann Crossley

• Marriage & Family Therapist in International Falls, MN
• Providers in International Falls, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.