Active NPI
Grant David Chikazawa-Nelson, PH.D., LMFT
- Marriage & Family Therapist
- Richfield, MN
National Provider Identifier
1760539787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 0943
- Practice address
- 6607 18TH Ave S
Suite 201
Richfield, MN 55423-2784 - Phone
- (612) 455-4040
- Fax
- (612) 455-4041
- NPI assigned
- Jan 4, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 0943 | MN | Primary |
Addresses
Primary practice location
6607 18TH Ave S
Suite 201
Richfield, MN 55423-2784
Mailing address
6607 18TH Ave S
Suite 201
Richfield, MN 55423-2784
Phone (612) 455-4040
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 540521 | Other | MN | BEHAVIORAL HEALTH PROVIDE |
| 540521 | Other | MN | VALUE OPTIONS |
| 540521 | Other | MN | BHP |
| 69B21CH | Other | MN | BCBS BLUEPLUS |
| 69B21CH | Other | MN | BCBS & BLUE PLUS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0943 | MN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760539787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6607 18TH AVE S",
"address_2": "SUITE 201",
"city": "RICHFIELD",
"state": "MN",
"postal_code": "554232784",
"telephone_number": "612-455-4040",
"fax_number": "612-455-4041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6607 18TH AVE S",
"address_2": "SUITE 201",
"city": "RICHFIELD",
"state": "MN",
"postal_code": "554232784",
"telephone_number": "612-455-4040",
"fax_number": "612-455-4041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHIKAZAWA-NELSON",
"first_name": "GRANT",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "PH.D., LMFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "0943",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEHAVIORAL HEALTH PROVIDE",
"identifier": "540521",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "540521",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BHP",
"identifier": "540521",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS BLUEPLUS",
"identifier": "69B21CH",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS & BLUE PLUS",
"identifier": "69B21CH",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Richfield, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.