Individual provider Active NPI

Tanya Brown

  • Marriage & Family Therapist
  • Golden Valley, MN
National Provider Identifier
1710549290
Registry record updated Jul 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
3723 Issued in MN
Practice address
8085 Wayzata Blvd Ste 215
Golden Valley, MN 55426-1457
Phone
(651) 387-5312
NPI assigned
Jul 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2019

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 3723 MN Primary

Addresses

Primary practice location

8085 Wayzata Blvd Ste 215
Golden Valley, MN 55426-1457

Mailing address

8085 Wayzata Blvd
Golden Valley, MN 55426-1453

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
I20250124002938 MN Practitioner - Marriage and Family Therapist 0446615769 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3723MNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vibrant Life Therapy LLC Marriage & Family Therapist CurrentSince Mar 1, 2023 Accepting new patients
Intuitive Therapy & Consulting, LLC Marriage & Family Therapist Past Accepting new patients

Locations

2205 White Bear Ave N
Ste 125
Maplewood, MN 55109
Phone (651) 208-9409

2055 White Bear Ave N
Ste 125
Saint Paul, MN 55109
Phone (651) 504-4285

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562112000000",
    "number": "1710549290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8085 WAYZATA BLVD",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554261453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8085 WAYZATA BLVD STE 215",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554261457",
            "telephone_number": "651-387-5312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "TANYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-03",
        "last_updated": "2019-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

Verify at the official NPI Registry.