Julia Edelman

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

3730 Issued in MN

Practice address

11505 36TH Ave N
Plymouth, MN 55441-2304

Phone

(763) 509-3945

NPI assigned

Dec 2, 2014

Last updated

Sep 18, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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

Specialty

Marriage and Family Therapist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakeshore Family Therapy LLCGroup PAC ID 3577081819, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lakeshore Family Therapy LLC

  • Marriage & Family Therapist
  • Wayzata, MN
  • NPI 1699179994
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1417478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1700283025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2610 IRVING AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554081047",
            "telephone_number": "612-805-1959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11505 36TH AVE N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554412304",
            "telephone_number": "763-509-3945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDELMAN",
        "first_name": "JULIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-02",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Kay Dunham
• Jessi Dvorak, DNP, APRN, CRNA
• Ayanna Amelia Easton
• Jayne Eberhardt, CRNA
• Alexander Eddy, MD
• Chase Edward Eder, OD
• Rachel Edman
• Diana Edmond
• Beth Edwards, D.O.
• Kristin M Egan, PA-C

• Marriage & Family Therapist in Plymouth, MN
• Providers in Plymouth, 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 Sep 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.