Mary Lisa Chedda, MA, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

4291 Issued in MN

Practice address

1500 McAndrews Rd W Ste 215
Burnsville, MN 55337-4445

Phone

(952) 222-3002

NPI assigned

Feb 22, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mary Little Former name

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, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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 and National Provider Directory roles.

• Life Interrupted Counseling Services

  • Adolescent and Children Mental Health Clinic/Center
  • Burnsville, MN
  • NPI 1033821632
  Medicare reassignment NPD Authorized official
• Associated Clinic of Psychology Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • St Louis Park, MN
  • NPI 1588741292
  NPD (past)

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

{
    "created_epoch": "1487721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1861931966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 MCANDREWS RD W STE 215",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553374445",
            "telephone_number": "952-222-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 MCANDREWS RD W STE 215",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553374445",
            "telephone_number": "952-222-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEDDA",
        "first_name": "MARY",
        "middle_name": "LISA",
        "credential": "MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-22",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "4291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033821632",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "LITTLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica Charis
• Dean Y. Charles, PSY.D.
• Adelaide J Charlton, WHNP
• Mallory Ann Chase, PT
• Davina Vasentbhai Chauhan
• Graceann Sarah Chelesvig
• Leland P Cheng, MD
• Wenlan Cheng, MD
• Raphael Cheron, HIS
• Heng Moy Chhour

• Marriage & Family Therapist in Burnsville, MN
• Providers in Burnsville, 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 Jan 18, 2024; 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.