Active NPI
Anna Bohlinger
- Marriage & Family Therapist
- Maple Grove, MN
National Provider Identifier
1720358286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 2514
- Practice address
- 12915 63Rd Ave N
Maple Grove, MN 55369-6001 - Phone
- (952) 826-8400
- Fax
- (952) 383-5802
- NPI assigned
- Dec 30, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Marriage & Family Therapist | 106H00000X | 2514 | MN | Primary |
Addresses
Primary practice location
12915 63Rd Ave N
Maple Grove, MN 55369-6001
Mailing address
1772 Stieger Lake LN.
P.O. Box 51
Victoria, MN 55386
Phone (952) 443-4600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2514 | MN | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lorenz Clinic, LLC | Marriage & Family Therapist | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/16506/brand/1/csg/1/fhir/r4
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.
-
- Marriage & Family Therapist
- Victoria, MN
- NPI 1982900510
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605052800000",
"number": "1720358286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1772 STIEGER LAKE LN.",
"address_2": "P.O. BOX 51",
"city": "VICTORIA",
"state": "MN",
"postal_code": "55386",
"telephone_number": "952-443-4600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12915 63RD AVE N",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553696001",
"telephone_number": "952-826-8400",
"fax_number": "952-383-5802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOHLINGER",
"first_name": "ANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-30",
"last_updated": "2020-11-11",
"certification_date": "2020-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "2514",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maple Grove, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.