Morgan Rae Lasalle, LMFT, BCBA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

3372 Issued in MN

Practice address

160 3Rd Ave NW
Milaca, MN 56353

Phone

(320) 983-2335

NPI assigned

Jun 12, 2012

Last updated

Nov 29, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1720340102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30605 100TH AVE",
            "city": "ONAMIA",
            "state": "MN",
            "postal_code": "563592162",
            "telephone_number": "320-733-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 3RD AVE NW",
            "city": "MILACA",
            "state": "MN",
            "postal_code": "56353",
            "telephone_number": "320-983-2335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1045 E. Pennsylvania Ave",
            "address_purpose": "LOCATION",
            "city": "Escondido",
            "state": "CA",
            "postal_code": "92025",
            "country_code": "US",
            "telephone_number": "619-241-1574",
            "fax_number": "619-243-7387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LASALLE",
        "first_name": "MORGAN",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "LMFT, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-12",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "82223",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3372",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-12-12579",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Milaca Family Dental, LLC

• Marriage & Family Therapist in Milaca, MN
• Providers in Milaca, 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 Nov 29, 2018; 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.