STACEY LYNN WOLFGRAM (NPI# 1346307873) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346307873 |
| Entity Type | Individual |
| Full Name | STACEY LYNN WOLFGRAM |
| Credential | MA, LMFT |
| Practice Address |
6900 78th Ave N Brooklyn Park MN 55445-2719 |
| Mailing Address |
410 Pebble Rd N Champlin MN 55316-1541 |
| Practice Telephone | 7635604412 |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 1337 | MN | Behavioral Health & Social Service Providers |
| Street Address |
6900 78TH AVE N |
| City | BROOKLYN PARK |
| State | MN |
| Zip Code | 55445-2719 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396724738 | Planned Parenthood Minnesota, North Dakota, South Dakota | Specialist | 6900 78th Ave N, Suite 103, Brooklyn Park, MN 55445-2719 | 2006-01-13 |
| 1477151165 | Nathan Murphy | Behavior Technician | 6900 78th Ave N, Brooklyn Park, MN 55445-2719 | 2020-10-14 |
| 1235791500 | Bailey Smith | Behavior Technician | 6900 78th Ave N, Brooklyn Park, MN 55445-2719 | 2019-07-08 |
| 1548822380 | Kelly Berth | Behavior Technician | 6900 78th Ave N, Brooklyn Park, MN 55445-2719 | 2019-07-02 |
| 1225504095 | Kasey Nicole Aune | Behavioral Analyst | 6900 78th Ave N, Brooklyn Park, MN 55445-2719 | 2018-10-19 |
| 1982055778 | Nancy Avila | Social Worker | 6900 78th Ave N, Brooklyn Park, MN 55445-2719 | 2016-06-23 |
| 1124259205 | Sonja Marie Sharp | Nurse Practitioner | 6900 78th Ave N, #103, Brooklyn Park, MN 55445-2719 | 2009-08-06 |
| 1902059751 | Stephanie Anne Brace | Marriage & Family Therapist | 6900 78th Ave N, Brooklyn Park, MN 55445-2719 | 2008-10-24 |
| 1912103110 | Seema K Kamath | Social Worker | 6900 78th Ave N, Brooklyn Park, MN 55445-2719 | 2007-06-25 |
| 1346308038 | Charles A Koch | Psychologist | 6900 78th Ave N, Brooklyn Park, MN 55445-2719 | 2006-12-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992305973 | Telepsychus | Counselor | 8518 South Maplebrook Circle, Brooklyn Park, MN 55445 | 2020-10-28 |
| 1548813447 | Camille Krashawn Eubanks | Driver | 6444 84thcourt, Brooklyn Park, MN 55445 | 2019-07-19 |
| 1881173276 | Altenin C Nguyen | Registered Nurse | 8706 Oregon Ave N, Brooklyn Park, MN 55445 | 2018-08-07 |
| 1760905475 | Patient Centered Care | Clinic/Center | 8240 Hampshire Ct N, Brooklyn Park, MN 55445 | 2017-07-25 |
| 1578001178 | Peaceful Living Professionals, LLC | Community/Behavioral Health | 6901 78th Ave No, Suite 102, Brooklyn Park, MN 55445 | 2017-02-03 |
| 1336594498 | Jaimi Weber | Family Medicine | Mmc 381, 420 Delaware St. Se, Minneapolis, MN 55445 | 2016-04-26 |
| 1174876171 | Rebecca Parkin | Occupational Therapist | 6732 83rd Place North, Brooklyn Park, MN 55445 | 2012-10-16 |
| 1942525928 | Timothy Anton Kelly | Home Health | 7954 Brooklyn Boulavard, 7954, Brooklyn Park, MN 55445 | 2010-04-01 |
| 1326270778 | Grand St Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 7996 Brooklyn Blvd., Brooklyn Park, MN 55445 | 2009-08-19 |
| 1194947101 | Ambereen F Suhrwardy | Dentist | 6612 98th Ln N, Brooklyn Park, MN 55445 | 2007-05-02 |
| Find all providers in zip 55445 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639636871 | Arianne Johnston | Marriage & Family Therapist | 8925 Zane Ave N, Brooklyn Park, MN 55443-1630 | 2019-02-25 |
| 1922513381 | Nicholas David Vasquez | Marriage & Family Therapist | 6840 78th Ave N, Brooklyn Park, MN 55445-2760 | 2017-12-07 |
| 1710267141 | David Swan | Marriage & Family Therapist | 7808 Scott Ave N, Brooklyn Park, MN 55443-3019 | 2011-08-17 |
| 1972028306 | Katie Ann Ullman | Marriage & Family Therapist | 9400 Zane Ave N, Brooklyn Park, MN 55443-1814 | 2017-08-07 |
| 1003337643 | Jennifer Anne Franke | Marriage & Family Therapist | 9400 Zane Ave N, Brooklyn Park, MN 55443-1814 | 2017-07-05 |
| 1548709140 | Suzanne E Derheim | Marriage & Family Therapist | 5500 94th Ave N, Brooklyn Park, MN 55443-1992 | 2017-02-15 |
| 1285095943 | Sarah Hoffman | Marriage & Family Therapist | 9400 Zane Ave N, Brooklyn Park, MN 55443 | 2016-03-09 |
| 1427414143 | Jamie Baker Barten | Marriage & Family Therapist | 9400 Zane Ave N, Brooklyn Park, MN 55443-1814 | 2016-01-11 |
| 1396182614 | Allison L Bohlke | Marriage & Family Therapist | 7000 78th Ave N, Brooklyn Park, MN 55445-2744 | 2013-05-28 |
| 1518205731 | Sarah Jane Neujahr | Marriage & Family Therapist | 2807 Brookdale Dr, Brooklyn Park, MN 55444-1844 | 2013-01-23 |
| Find all providers in BROOKLYN PARK | ||||
| City | BROOKLYN PARK |
| Zip Code | 55445 |
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| 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.