Mardea Tellewoyankamara

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

9120 Springbrook Dr NW
Coon Rapids, MN 55433-5845

Phone

(763) 231-2590

NPI assigned

Feb 2, 2026

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mardea Princess Tellewoyankamara Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Fraser

  • Rehabilitation Clinic/Center
  • Richfield, MN
  • NPI 1063568574
  NPD (past)
• Fraser Child and Family Center

  • Adolescent and Children Mental Health Clinic/Center
  • Minneapolis, MN
  • NPI 1609922194
  NPD (past)

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

{
    "created_epoch": "1769990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769990400000",
    "number": "1972453587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9120 SPRINGBROOK DR NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335845",
            "telephone_number": "763-231-2590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9120 SPRINGBROOK DR NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335845",
            "telephone_number": "763-231-2590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLEWOYANKAMARA",
        "first_name": "MARDEA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-02",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARDEA",
            "last_name": "TELLEWOYANKAMARA",
            "middle_name": "PRINCESS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lastara Taylor
• Molly Teigen, PA-C
• Louis Fomum Tekock
• Brian L Tell, MD
• Nicole Tellander, OTR/L
• Julie A. Tenbrook, NP
• Rebecca D Tenney, CRNA
• Amanda Terwey
• Brittani Lynn Terwilliger, MS
• Ruth Ellen Tessmer

• Behavior Technician in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Behavior Technician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.