JUDITH LOUISE ROSS AGUSTIN


Address: 8100 Penn Ave S Ste 150h, Bloomington, MN 55431-1346
Phone: 6123146012

JUDITH LOUISE ROSS AGUSTIN (NPI# 1003195082) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1003195082
Entity Type Individual
Full Name JUDITH LOUISE ROSS AGUSTIN
Credential M.S., LMFT
Practice Address 8100 Penn Ave S Ste 150h
Bloomington
MN 55431-1346
Practice Telephone 6123146012
Mailing Telephone 6123146012
Enumeration Date 2011-08-09
Last Update Date 2019-06-10
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 106H00000X Marriage & Family Therapist 2534 MN Behavioral Health & Social Service Providers
N 106H00000X Marriage & Family Therapist MT2659 FL Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
GROUP/BUSINESS ENTITY 1528451028 01

Office Location

Street Address 8100 PENN AVE S STE 150H
City BLOOMINGTON
State MN
Zip Code 55431-1346

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1780033076 Yasin Jama Contractor 9810 Drew Avenue South, Apartment 106, Bloomington, MN 55431 2016-06-07
1972961001 Kadar Hadis Social Worker 8200 Humboldt Ave S Ste 217, Bloomington, MN 55431 2016-02-03
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Taxonomy Information

Taxonomy Code 106H00000X
Grouping Behavioral Health & Social Service Providers
Classification Marriage & Family Therapist

Taxonomy Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1770092546 Jessica Parker Marriage & Family Therapist 10624 Xavier Ave S, Bloomington, MN 55437-2726 2017-09-25
1366782336 Anna Hollerich Marriage & Family Therapist 9048 Johnson Ave S, Bloomington, MN 55437-1806 2013-02-27
1548514136 Katelyn J Minelli Marriage & Family Therapist 1136 W 17th St, Suite B, Bloomington, IN 47404-3002 2012-11-03
1093061301 The Minnesota Center for Couples and Family Therapy, LLC Marriage & Family Therapist 1120 E 80th St, Suite 200, Bloomington, MN 55420-1462 2012-07-24
1093088544 Timothy James Kaehr Marriage & Family Therapist 1801 American Blvd E, Suite 1, Bloomington, MN 55425-1232 2012-02-14
1477786218 Schuyler Fisk Seager Vi Marriage & Family Therapist 1000 E 80th St, Bloomington, MN 55420-1424 2009-08-27
1740409242 Erin Elizabeth Leach Marriage & Family Therapist 140 W 98th St, Suite 222, Bloomington, MN 55420-4865 2007-04-24
1073646964 Joseph D Strano Marriage & Family Therapist 2 Whites Pl, Bloomington, IL 61701-1860 2007-03-13
1639236144 Heidi D Schmidt Marriage & Family Therapist 9201 E Bloomington Fwy Ste Q, Bloomington, MN 55420-3413 2007-01-03
1497811780 Peter James Hartwich Marriage & Family Therapist 1101 E 78th St, Bloomington, MN 55420-1400 2006-12-29
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Competitor

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City BLOOMINGTON
Zip Code 55431

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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