Individual provider Active NPI

Katherine Ann Patras Legut, L.M.F.T.

  • Marriage & Family Therapist
  • Lakeville, MN
National Provider Identifier
1760540272
Registry record updated May 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1448 Issued in MN
Practice address
7580 160TH St W
Lakeville, MN 55044-8348
Phone
(952) 898-1133
NPI assigned
Dec 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2020

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 1448 MN Primary

Addresses

Primary practice location

7580 160TH St W
Lakeville, MN 55044-8348

Mailing address

2115 County Road D E
Suite B
Maplewood, MN 55109-5353
Phone (651) 748-5019

Other practice location 1

2115 County Road D E
Suite B
Maplewood, MN 55109-5353
Phone (651) 748-5019

Other identifiers 4

IdentifierTypeStateIssuer
275226OtherMNCOMPSYCH EAP
390K1PAOtherMNBLUE CROSS BLUE SHIELD
766181900MedicaidMN
HP65335OtherMNHEALTH PARTNERS

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
I20231220002984 MN Practitioner - Marriage and Family Therapist 5991155665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Life Development Resources PAGroup PAC ID 5890779847, 20 clinicians

Practice addresses (Care Compare)

7580 160TH St W
Lakeville, MN 55044-8348
Phone (952) 898-1133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1448MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Life Development Resources, PA Marriage & Family Therapist CurrentSince Jan 1, 2024 Accepting new patients

Locations

7580 160th St W
Lakeville, MN 55044
Phone (952) 898-1133

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": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1760540272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 COUNTY ROAD D E",
            "address_2": "SUITE B",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551095353",
            "telephone_number": "651-748-5019",
            "fax_number": "651-773-7591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7580 160TH ST W",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550448348",
            "telephone_number": "952-898-1133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2115 County Road D E",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Maplewood",
            "state": "MN",
            "postal_code": "551095353",
            "country_code": "US",
            "telephone_number": "651-748-5019",
            "fax_number": "651-773-7591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATRAS LEGUT",
        "first_name": "KATHERINE",
        "middle_name": "ANN",
        "credential": "L.M.F.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPSYCH EAP",
            "identifier": "275226",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "390K1PA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "766181900",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP65335",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, MN

Sources for this page

Verify at the official NPI Registry.