Staci Leigh Born, ED.D., LMFT, RPT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

2566 Issued in MN

Practice address

108 Waynesborough Way
Mankato, MN 56001-6457

Phone

(507) 380-0626

NPI assigned

Jun 29, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• The Blue Couch

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mankato, MN
  • NPI 1780335505
  NPD Authorized official

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

{
    "created_epoch": "1372464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1831539261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 WAYNESBOROUGH WAY",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560016457",
            "telephone_number": "507-380-0626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 WAYNESBOROUGH WAY",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560016457",
            "telephone_number": "507-380-0626"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1305 Christine Cir",
            "address_purpose": "LOCATION",
            "city": "Brookings",
            "state": "SD",
            "postal_code": "570064178",
            "country_code": "US",
            "telephone_number": "507-380-0626",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1051 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "Mankato",
            "state": "MN",
            "postal_code": "560016143",
            "country_code": "US",
            "telephone_number": "507-386-7121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORN",
        "first_name": "STACI",
        "middle_name": "LEIGH",
        "credential": "ED.D., LMFT, RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-29",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "SD",
            "license": "LMFT1230",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelyn M Bolte
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• Erin Borneke
• Kaitlyn Borneke, PA
• Bradley Dean Borresen, RPH
• Jerome Borth, R.PH.
• Bosaso Translation Services & Interpretation

• Marriage & Family Therapist in Mankato, MN
• Providers in Mankato, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.