Nicole Knudson-Dalal, LMFT, LADC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

2440 Issued in MN

Practice address

5275 Edina Industrial Blvd Ste 103
Edina, MN 55439-2915

Phone

(612) 636-1083

NPI assigned

Nov 9, 2015

Last updated

Nov 9, 2015By the provider in NPPES

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

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, 2010

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cedar Valley Center for Child & Family Therapy, PLLC

  • Preferred Provider Organization
  • Eagan, MN
  • NPI 1518362193
  Medicare reassignment NPD

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

{
    "created_epoch": "1447027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447027200000",
    "number": "1952774218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5275 EDINA INDUSTRIAL BLVD STE 103",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392915",
            "telephone_number": "612-636-1083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5275 EDINA INDUSTRIAL BLVD STE 103",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392915",
            "telephone_number": "612-636-1083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUDSON-DALAL",
        "first_name": "NICOLE",
        "credential": "LMFT, LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-09",
        "last_updated": "2015-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303607",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Jolaine Knapp, N.P.
• Joseph Thomas Knapper, M.D.
• Stephen Rudy Knier, D.O.
• Gayle Lencowski Knopik, LADC
• Joseph Knowles, RN
• Patricia Knudson
• Jennifer A. Knutsen, MD
• Amy Jo Kobielush, ATC
• Christine Rae Koch, OTR/L, CLT
• Jason John Koch, MD

• Marriage & Family Therapist in Edina, MN
• Providers in Edina, 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 Nov 9, 2015; 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.