Robert Clemons, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

3875 Issued in MN

Practice address

110 6TH Ave S
Saint Cloud, MN 56301-5209

Phone

(320) 253-5930

Fax

(651) 925-0057

NPI assigned

Dec 29, 2019

Last updated

Oct 12, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Marriage and Family Therapist

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Village Family Service CenterGroup PAC ID 7517857428, 27 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Village Family Service Center

  dba The Village Family Service Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fargo, ND
  • NPI 1568492353

  Marriage & Family Therapist, MN

  Medicare reassignment Care Compare group NPD
• Village Family Service Center

  dba The Village Family Service Center

  • Substance Abuse Rehabilitation Facility
  • Fargo, ND
  • NPI 1952679318
  NPD

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

{
    "created_epoch": "1577577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1841839503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9859",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581069859",
            "telephone_number": "701-451-4900",
            "fax_number": "651-925-0057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 6TH AVE S",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563015209",
            "telephone_number": "320-253-5930",
            "fax_number": "651-925-0057"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13045 Falcon Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Baxter",
            "state": "MN",
            "postal_code": "564254201",
            "country_code": "US",
            "telephone_number": "218-282-7439",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "407 130th Ave S",
            "address_purpose": "LOCATION",
            "city": "Onamia",
            "state": "MN",
            "postal_code": "563593115",
            "country_code": "US",
            "telephone_number": "320-532-4005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLEMONS",
        "first_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-29",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer L Clark, PHARMD, BCCCP
• Paul Allen Clark, OTR/L
• Tashia Clark
• Benjamin Clemenson
• Alyssa Clements, PA-C
• Lyndsay Cloarec
• Cloud Home Health Care Services LLC
• Zachary Scott Clouse
• Rebecca Ann Cluever
• Joseph Coalwell, RN

• Marriage & Family Therapist in Saint Cloud, MN
• Providers in Saint Cloud, 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 Oct 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.