Individual provider Active NPI

Colleen Marie Lacey, LMFT

  • Marriage & Family Therapist
  • Brooklyn Park, MN
National Provider Identifier
1861709529
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2204 Issued in MN
Practice address
9400 Zane Ave N
Brooklyn Park, MN 55443-1814
Phone
(952) 826-8475
Fax
(763) 315-4669
NPI assigned
Sep 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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 2204 MN Primary

Addresses

Primary practice location

9400 Zane Ave N
Brooklyn Park, MN 55443-1814

Mailing address

9400 Zane Ave N
Brooklyn Park, MN 55443-1814
Phone (952) 826-8475

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
I20250602001057 MN Practitioner - Marriage and Family Therapist 1759890718 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Croix Psychiatric LLCGroup PAC ID 9335288786, 45 clinicians

Practice addresses (Care Compare)

9400 Zane Ave N
Brooklyn Park, MN 55443-1814
Phone (952) 826-8475

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
St. Croix Psychiatric, LLC Marriage & Family Therapist CurrentSince Mar 23, 2025 Accepting new patients

Locations

9400 Zane Ave N
Minneapolis, MN 55443
Phone (763) 383-5800

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": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1861709529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 ZANE AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431814",
            "telephone_number": "952-826-8475",
            "fax_number": "763-315-4669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 ZANE AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431814",
            "telephone_number": "952-826-8475",
            "fax_number": "763-315-4669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACEY",
        "first_name": "COLLEEN",
        "middle_name": "MARIE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-01",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn Park, MN

Sources for this page

Verify at the official NPI Registry.