Family Innovations, Inc.
Organization Active NPI Counseling Psychologist · Anoka, MN
NPI 1992862783 · NPPES record last updated Mar 20, 2024
Key facts
- NPI
- 1992862783
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Counseling Psychologist 103TC1900X
- Legal business name
- FAMILY INNOVATIONS, INC.
- Practice address
- 1833 3Rd Ave
Anoka, MN 55303-2424 - Phone
- (763) 421-5535
- Fax
- (763) 433-0226
- NPI assigned
- Jan 2, 2007
- Organization subpart
- No
Authorized official
- Name
- Ryan Pardo
- Title
- Chief Legal Officer
- Phone
- (206) 399-1493
Practitioners 327
-
Babatunde Safiriyu Adams, PMHNP-BC
-
Nargiza S. Akyol, NP
-
Cassie Anderson, MA LPC
-
Paula Kay Anderson, MA, LPCC, LADC
-
Madison Andrews, LPCC
-
Jax Taylor Baker, LPC
-
Nicole Szudy Buatala, RN, MSN, FNP, PMHNP
-
Rochelle L Carrick, LICSW
-
Prakriti Chaulagain, MSN , PMHNP-BC
-
Tamara Clement, PH.D., L.P.
-
Kayla Clint, LMFT
-
Jacqueline Rose Cooper, RN, CNP
-
Monica Guzdkiewicz Daugherty, APRN, CNM, PMHNP
-
Matthew Ryan Delamatter, M.A.
-
Kara Ann Engebretson, LICSW
-
James Tutu Fiske I, DNP/PMHNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190506002814 | MN | Part B Supplier - Clinic/Group Practice | 6204178528 |
Receives reassigned benefits from 127 practitioners Practice locations: Anoka, MN; St. Paul, MN; St Louis Park, MN; Saint Paul, MN; Plymouth, MN; Maplewood, MN; Maple Grove, MN; Eden Prairie, MN… |
National Provider Directory
Locations
1833 3rd Ave
Anoka, MN 55303
Phone (763) 421-5535
6800 78th Ave N
Ste 101
Brooklyn Park, MN 55445
Phone (612) 314-0349
7525 Mitchell Rd
Ste 100
Eden Prairie, MN 55344
Phone (952) 224-2282
7041 20th Ave
Hugo, MN 55038
Phone (651) 407-3631
9325 Upland Ln N
Ste 210
Maple Grove, MN 55369
Phone (612) 453-4966
3601 Minnesota Dr
Ste 170
Minneapolis, MN 55435
Phone (612) 924-1421
3007 Harbor Ln N
Ste 1600
Plymouth, MN 55447
Phone (651) 748-5019
2103 County Road D E
Ste B
Saint Paul, MN 55109
Phone (651) 383-4800
2270 Ford Pkwy
Saint Paul, MN 55116
Phone (651) 696-5000
2270 Ford Pkwy
Ste 106
Saint Paul, MN 55116
Phone (651) 724-9411
5353 Wayzata Blvd
Ste 200
St Louis Park, MN 55416
Phone (612) 281-5764
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor |
101YP2500X | |||
| Clinical Psychologist |
103TC0700X | |||
| Counseling Psychologist |
103TC1900X | Yes | ||
| Clinical Social Worker |
1041C0700X | |||
| Marriage & Family Therapist |
106H00000X | |||
| Community/Behavioral Health Agency | 251S00000X | |||
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X |
Addresses
Primary practice location
1833 3Rd Ave
Anoka, MN 55303-2424
Mailing address
1833 3Rd Ave
Anoka, MN 55303-2424
Phone (763) 421-5535
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 211588 | Other | MN | COMPSYCH EAP |
| 086M6FA | Other | MN | BLUE CROSS BLUE SHIELD |
| 04033007 | Other | MN | METROPOLITAN HEALTH PLAN |
| 300P0FA | Other | MN | BLUE CROSS BLUE SHIELD |
| 48G90FA | Other | MN | BLUE CROSS BLUE SHIELD |
| 81312 | Other | MN | HEALTH PARTNERS |
| 026665500 | Medicaid | MN |
Other names
- LifeStance Health
Other providers in Anoka, MN
- Rachael Bauleke Faeth
- Angela Fahey
- Kamal Mohamad Fakhreddine
- Family Comfort Hospices Care
- Family Comfort Service LLC
- Family Orthodontic Specialists PLC
- Rahmo Farah
- James Michael Farm
- Erika Farrell
- Dana Marie Feia
All providers in Anoka, MN · Counseling Psychologist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.