Individual provider Active NPI

Tao Lee, LMFT

  • Marriage & Family Therapist
  • Maplewood, MN
National Provider Identifier
1891560322
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4272 Issued in MN
Practice address
2001 Beam Ave
Maplewood, MN 55109-1401
Phone
(952) 826-8475
Fax
(651) 209-0514
NPI assigned
Nov 15, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 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 4272 MN Primary

Addresses

Primary practice location

2001 Beam Ave
Maplewood, MN 55109-1401

Mailing address

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

Other practice location 1

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
I20240416001587 MN Practitioner - Marriage and Family Therapist 4688013204 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4272MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Croix Psychiatric, LLC Marriage & Family Therapist CurrentSince Mar 4, 2024 Accepting new patients
Prairiecare LLC Marriage & Family Therapist PastSince Nov 19, 2023 Accepting new patients

Locations

2001 Beam Ave
Maplewood, MN 55109
Phone (952) 737-4500

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

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1700006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1891560322",
    "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": "2001 BEAM AVE",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091401",
            "telephone_number": "952-826-8475",
            "fax_number": "651-209-0514"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9400 Zane Ave N",
            "address_purpose": "LOCATION",
            "city": "Brooklyn Park",
            "state": "MN",
            "postal_code": "554431814",
            "country_code": "US",
            "telephone_number": "952-826-8475",
            "fax_number": "763-315-4669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "TAO",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-15",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "4272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

Verify at the official NPI Registry.