Individual provider Active NPI

Nichole Marie Sommerhauser Kubes, MA, LMFT

  • Marriage & Family Therapist
  • Roseville, MN
National Provider Identifier
1851922009
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
3124 Issued in MN
Practice address
2233 Hamline Ave N Ste 435
Roseville, MN 55113-5023
Phone
(612) 444-9781
Fax
(651) 846-4899
NPI assigned
Jan 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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 3124 MN Primary

Addresses

Primary practice location

2233 Hamline Ave N Ste 435
Roseville, MN 55113-5023

Mailing address

2233 Hamline Ave N Ste 435
Roseville, MN 55113-5023
Phone (612) 444-9781

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240606000632 MN Practitioner - Marriage and Family Therapist 9830631878 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Nathan & Associates, LLC CurrentSince Mar 20, 2024 Accepting new patients

Locations

2233 Hamline Ave N
Ste 435
Saint Paul, MN 55113
Phone (612) 444-9781

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": "1580083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1851922009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 HAMLINE AVE N STE 435",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551135023",
            "telephone_number": "612-444-9781",
            "fax_number": "651-846-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 HAMLINE AVE N STE 435",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551135023",
            "telephone_number": "612-444-9781",
            "fax_number": "651-846-4899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMMERHAUSER KUBES",
        "first_name": "NICHOLE",
        "middle_name": "MARIE",
        "credential": "MA, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-27",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

Verify at the official NPI Registry.