Individual provider Active NPI

Marta Marie Tolefree, LICSW

  • Athletic Trainer
  • Lake Elmo, MN
National Provider Identifier
1841869765
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
20345 Issued in MN
Practice address
9309 6TH Street CT N
Lake Elmo, MN 55042-4120
Phone
(651) 235-6962
NPI assigned
Jun 24, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 20345 MN Primary

Addresses

Primary practice location

9309 6TH Street CT N
Lake Elmo, MN 55042-4120

Mailing address

9309 6TH Street CT N
Lake Elmo, MN 55042-4120
Phone (651) 235-6962

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1624492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1841869765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9309 6TH STREET CT N",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550424120",
            "telephone_number": "651-235-6962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9309 6TH STREET CT N",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550424120",
            "telephone_number": "651-235-6962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLEFREE",
        "first_name": "MARTA",
        "middle_name": "MARIE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-24",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "20345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elmo, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; 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.