Individual provider Active NPI

Amy Carol Gold, MA; LMFT

  • Marriage & Family Therapist
  • Minneapolis, MN
National Provider Identifier
1770724924
Registry record updated Apr 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT1146 Issued in MN
Practice address
1409 Willow St
Suite 600
Minneapolis, MN 55403-2269
Phone
(612) 872-2343
Fax
(360) 233-0649
NPI assigned
Mar 18, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2014

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 LMFT1146 MN Primary

Addresses

Primary practice location

1409 Willow St
Suite 600
Minneapolis, MN 55403-2269

Mailing address

1409 Willow St
Suite 600
Minneapolis, MN 55403-2269
Phone (612) 872-2343

Other identifiers 1

IdentifierTypeStateIssuer
M488355100OtherMNMEDICAL ASSISSTANCE

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
I20260623000026 MN Practitioner - Marriage and Family Therapist 6002389079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

9531 W 78TH St
Suite 220
Eden Prairie, MN 55344-3863

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT1146MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Calm-Clinic for Attention, Learning, and Memor Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1237334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396483200000",
    "number": "1770724924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 WILLOW ST",
            "address_2": "SUITE 600",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554032269",
            "telephone_number": "612-872-2343",
            "fax_number": "360-233-0649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 WILLOW ST",
            "address_2": "SUITE 600",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554032269",
            "telephone_number": "612-872-2343",
            "fax_number": "360-233-0649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLD",
        "first_name": "AMY",
        "middle_name": "CAROL",
        "credential": "MA; LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-18",
        "last_updated": "2014-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "LMFT1146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISSTANCE",
            "identifier": "M488355100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.