Individual provider Active NPI

Connie L. Carlson, LAMFT

  • Marriage & Family Therapist
  • Golden Valley, MN
National Provider Identifier
1851527477
Registry record updated Jun 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1834 Issued in MN
Practice address
7600 Wayzata Blvd
Suite 5B
Golden Valley, MN 55426-1645
Phone
(612) 810-8146
NPI assigned
Jun 10, 2009
Last updated
Jun 10, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2009

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 1834 MN Primary

Addresses

Primary practice location

7600 Wayzata Blvd
Suite 5B
Golden Valley, MN 55426-1645

Mailing address

7600 Wayzata Boulevard
Suite 5B
Golden Valley, MN 55426
Phone (612) 810-8146

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

State licenses

LicenseStateTypeSpecialty
1834MNMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1244592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244592000000",
    "number": "1851527477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 WAYZATA BOULEVARD",
            "address_2": "SUITE 5B",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "55426",
            "telephone_number": "612-810-8146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 WAYZATA BLVD",
            "address_2": "SUITE 5B",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554261645",
            "telephone_number": "612-810-8146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "CONNIE",
        "middle_name": "L.",
        "credential": "LAMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-10",
        "last_updated": "2009-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2009; 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.