Individual provider Active NPI

Tonya De Toutge, LMFT

  • Marriage & Family Therapist
  • Minneapolis, MN
National Provider Identifier
1780348896
Registry record updated Nov 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4267 Issued in MN
Practice address
3133 Hennepin Ave
Minneapolis, MN 55408-2620
Phone
(612) 524-9944
NPI assigned
Oct 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2024

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 4267 MN Primary

Addresses

Primary practice location

3133 Hennepin Ave
Minneapolis, MN 55408-2620

Mailing address

621 W Lake St Ste 350
Minneapolis, MN 55408-2952
Phone (612) 524-9944

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective May 5, 2026 through May 5, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4267MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lyn-Lake Psychotherapy and Wellness LTD. CurrentSince Jul 1, 2024 Accepting new patients

Locations

621 W Lake St
Ste 350
Minneapolis, MN 55408
Phone (612) 547-9990

2900 Thomas Ave S
Ste 100
Minneapolis, MN 55416

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": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732752000000",
    "number": "1780348896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 W LAKE ST STE 350",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082952",
            "telephone_number": "612-524-9944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3133 HENNEPIN AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082620",
            "telephone_number": "612-524-9944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOUTGE",
        "first_name": "TONYA",
        "middle_name": "DE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-25",
        "last_updated": "2024-11-28",
        "certification_date": "2024-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "4267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.