Individual provider Active NPI

Nancy Lynn Kerian, MA, LMFT

  • Marriage & Family Therapist
  • West St Paul, MN
National Provider Identifier
1700952769
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1381 Issued in MN
Practice address
149 Thompson Ave E Ste 150
West St Paul, MN 55118-3238
Phone
(651) 450-0860
Fax
(651) 450-0759
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1381 MN Primary

Addresses

Primary practice location

149 Thompson Ave E Ste 150
West St Paul, MN 55118-3238

Mailing address

4240 Park Glen Rd
St Louis Park, MN 55416-5427
Phone (612) 925-6033

Other identifiers 3

IdentifierTypeStateIssuer
335498900MedicaidMN
HP53833OtherMNHEALTHPARTNERS
136665C154OtherMNUCARE

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
I20240820003958 MN Practitioner - Marriage and Family Therapist 6507304680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Clinic of Psychology IncGroup PAC ID 0749171320, 136 clinicians

Practice addresses (Care Compare)

149 Thompson Ave E
Suite 150
West St Paul, MN 55118-3238
Phone (651) 450-0860

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1381MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Clinic of Psychology Inc CurrentSince Jun 8, 2024 Accepting new patients

Locations

4240 Park Glen Rd
St Louis Park, MN 55416
Phone (612) 925-6033

4027 County Road 25
St Louis Park, MN 55416
Phone (612) 925-6033

149 Thompson Ave E
Ste 150
West St Paul, MN 55118
Phone (651) 450-0860

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1700952769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4240 PARK GLEN RD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554165427",
            "telephone_number": "612-925-6033",
            "fax_number": "612-925-8496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 THOMPSON AVE E STE 150",
            "city": "WEST ST PAUL",
            "state": "MN",
            "postal_code": "551183238",
            "telephone_number": "651-450-0860",
            "fax_number": "651-450-0759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERIAN",
        "first_name": "NANCY",
        "middle_name": "LYNN",
        "credential": "MA, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "335498900",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP53833",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "136665C154",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West St Paul, MN

Sources for this page

Verify at the official NPI Registry.