Individual provider Active NPI

Alison Lynn Rusk Wiegman, L.M.F.T.

  • Marriage & Family Therapist
  • New Brighton, MN
National Provider Identifier
1922401058
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2850 Issued in MN
Practice address
1900 Silver Lake Rd NW
New Brighton, MN 55112-1786
Phone
(651) 628-9566
Fax
(651) 628-0411
NPI assigned
Oct 3, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2024

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 2850 MN Primary

Addresses

Primary practice location

1900 Silver Lake Rd NW
New Brighton, MN 55112-1786

Mailing address

614 Hawthorne St Ste 2
Alexandria, MN 56308-1662
Phone (320) 429-8554

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 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2850MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Heal Whole Health Therapy, PLLC CurrentSince May 19, 2024 Accepting new patients

Locations

614 Hawthorne St
Ste 2
Alexandria, MN 56308
Phone (320) 429-8554

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": "1412294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1922401058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 HAWTHORNE ST STE 2",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563081662",
            "telephone_number": "320-429-8554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121786",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSK WIEGMAN",
        "first_name": "ALISON",
        "middle_name": "LYNN",
        "credential": "L.M.F.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-03",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brighton, MN

Sources for this page

Verify at the official NPI Registry.