Individual provider Active NPI

Elizabeth Klein, LMFT

  • Marriage & Family Therapist
  • Saint Paul, MN
National Provider Identifier
1922372069
Registry record updated Jul 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
3661 Issued in MN
Practice address
1599 Selby Ave Ste 105LL
Saint Paul, MN 55104
Phone
(612) 470-0991
Fax
(833) 391-3575
NPI assigned
Mar 7, 2012
Last updated
Jul 20, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 4889 WI
Marriage & Family Therapist 106H00000X 1160 WI
Marriage & Family Therapist 106H00000X 3661 MN Primary

Addresses

Primary practice location

1599 Selby Ave Ste 105LL
Saint Paul, MN 55104

Mailing address

1599 Selby Ave Ste 105LL
Saint Paul, MN 55104-6375
Phone (612) 470-0991

Other practice location 1

2550 N 67th St
Wauwatosa, WI 53213-1443
Phone (414) 339-5494

Other practice location 2

1599 Selby Ave Ste 105Ll
Saint Paul, MN 55104
Phone (612) 470-0991

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 4, 2024 through Jan 4, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4889WIMDProfessional Counselor
3661MNMDMarriage & Family Therapist
1160WIMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563580800000",
    "number": "1922372069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1599 SELBY AVE STE 105LL",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046375",
            "telephone_number": "612-470-0991",
            "fax_number": "833-391-3575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1599 SELBY AVE STE 105LL",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55104",
            "telephone_number": "612-470-0991",
            "fax_number": "833-391-3575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2550 N 67th St",
            "address_purpose": "LOCATION",
            "city": "Wauwatosa",
            "state": "WI",
            "postal_code": "532131443",
            "country_code": "US",
            "telephone_number": "414-339-5494",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1599 Selby Ave Ste 105Ll",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "55104",
            "country_code": "US",
            "telephone_number": "612-470-0991",
            "fax_number": "833-391-3575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "ELIZABETH",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-07",
        "last_updated": "2019-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4889",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "1160",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.