Family Based Therapy Associates
Organization Active NPI Community/Behavioral Health Agency · Chisago City, MN
NPI 1891100293 · NPPES record last updated Jun 24, 2014
Key facts
- NPI
- 1891100293
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- License
- 00789 (MN)
- Legal business name
- FAMILY BASED THERAPY ASSOCIATES
- Practice address
- 11549 Lake LN
Suite 2
Chisago City, MN 55013-9830 - Phone
- (651) 257-2733
- Fax
- (651) 257-2783
- NPI assigned
- Jun 24, 2014
- Organization subpart
- No
Authorized official
- Name
- Randall Wallace, LP
- Title
- Director
- Phone
- (763) 780-1520
Corporate family (same tax ID) 1
Practitioners 44
-
Randall Dean Wallace, M.S.
-
Rikki Alstad, LMFT
-
Courtney Marie Bagley, M.A. LMFT
-
Natasha Barnes, LMFT
-
Gary Rex Beaver, M.A.
-
Adrea Davina Beres, LICSW
-
Agnes Boksa, PSYD
-
Jeffrey Brown, MA LP
-
Timothy McIntosh Day, M.S.W., L.I.C.S.W.
-
Jennifer Marie Decker, LMFT
-
Douglas Alan Drew, MA, LICSW
-
Judith Ann Driscoll, L.M.F.T.
-
Janet Lee Erickson, LMFT
-
John Dwight Ferguson, LICSW
-
Sheila Kathryn Forbes, M.S.S.W.
-
Marnie Lee Harper, LMFT
-
Allyson M Hayward, L.I.C.S.W.
-
Sheila Hermes, M.ED., LPCC, LADC
-
Kristi Mae Johnson Zempel, MSW LICSW MBA
-
Gretchen Lea Kafer, PSY.D.
-
Michelle Kahler, LMFT
-
Robert Stewart Lininger, PH.D.
National Provider Directory
- Tax ID family
- Family Based Therapy Associates
Locations
11549 Lake Ln
Ste 2
Chisago City, MN 55013
Phone (651) 257-2733
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 00789 | MN | Yes |
Addresses
Primary practice location
11549 Lake LN
Suite 2
Chisago City, MN 55013-9830
Mailing address
199 Coon Rapids Blvd NW
Suite 306
Coon Rapids, MN 55433-5831
Phone (763) 780-1520
Other providers in Chisago City, MN
- Ecumen
- Elan Acupuncture LLC
- Lynn Marie Fagen Moore
- Fairview Clinics
- Fairview Pharmacy Services LLC
- Susan Flannigan
- Charles Michael Gramling
- Gregory Contracting Inc.
- Thomas Paul Gustafson
- Marnie Lee Harper
All providers in Chisago City, MN · Community/Behavioral Health Agency in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.