LATARSHA NICOLE BRONAUGH (NPI# 1902255441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902255441 |
| Entity Type | Individual |
| Full Name | LATARSHA NICOLE BRONAUGH |
| Credential | LPCC |
| Practice Address |
3490 Lexington Ave North Suite 205 Shoreview MN 55126 |
| Mailing Address |
3490 Lexington Ave. N. Suite 205 Shoreview MN 55126 |
| Practice Telephone | 6514863808 |
| Mailing Telephone | 6514863808 |
| Mailing Fax Number | 6514863858 |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2016-10-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | MN | Behavioral Health & Social Service Providers |
| Street Address |
3490 LEXINGTON AVE NORTH SUITE 205 |
| City | SHOREVIEW |
| State | MN |
| Zip Code | 55126 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174184964 | Natural Smiles Dental Care | Clinic/Center | 3434 Lexington Ave. N, Suite 700, Shoreview, MN 55126 | 2019-06-24 |
| 1588194740 | Michael Simons | Hearing Instrument Specialist | 1007 Tiller Lane, Shoreview, MN 55126 | 2017-06-19 |
| 1265809479 | Emily Elizabeth Bade | Social Worker | 3490 Lexington Ave. N, Suite 205, Shoreview, MN 55126 | 2015-08-24 |
| 1669857520 | Laurel Ann Walsh | Marriage & Family Therapist | 3490 Lexington Ave. N., Suite 205, Shoreview, MN 55126 | 2015-07-21 |
| 1598150930 | Nova Bhs | Psychologist | 521 Tanglewood Dr., Shoreview, MN 55126 | 2015-04-02 |
| 1144570714 | Healthstat Arkansas/pace Ind.- St. Paul | Preventive Medicine | 3737 Lexington Ave. N, St. Paul, MN 55126 | 2012-09-11 |
| 1679843619 | Shoreview Dental Associates | Dentist | 4700 Lexington Avenue N, Suite D, Shoreview, MN 55126 | 2012-01-09 |
| 1700039575 | Jacqueline Elizabeth Hoppenrath | Audiologist | 4570 Churchill St Ste 130, Shoreview, MN 55126 | 2008-10-24 |
| 1164545935 | Lucia Jane Lein | Chiropractor | 1000 W. County Rd. E, 210, Shoreview, MN 55126 | 2007-04-09 |
| 1457426652 | F Douglas Whiting | Internal Medicine | 3585 North Lexington Ave Suite 135, Arden Hills, MN 55126 | 2006-11-22 |
| Find all providers in zip 55126 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124365234 | Bradley Denver Goodell Jr. | Counselor | 500 Highway 96 W, Suite 400, Shoreview, MN 55126-1944 | 2013-01-09 |
| 1356599856 | Courtney Marie Leclair | Counselor | 500 Highway 96 W, Suite 400, Shoreview, MN 55126-1944 | 2008-09-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588278444 | Sam Chafos Trewick | Counselor | 3237 Fremont Ave S, Minneapolis, MN 55408-3531 | 2020-09-08 |
| 1962026781 | Dylan Thaemert | Counselor | 2012 Bryant Ave S Ste 1, Minneapolis, MN 55405-2819 | 2020-06-08 |
| 1134742307 | Lyon Counseling LLC | Counselor | 4707 Highway 61 N # 1029, White Bear Lake, MN 55110-3227 | 2020-05-22 |
| 1457986556 | Jon Brookson Engfer | Counselor | 8609 Lyndale Avenue South, Bloomington, MN 55420 | 2020-03-09 |
| 1831735141 | Jon Walter Petersen | Counselor | 4136 Queen Ave S Apt 100, Minneapolis, MN 55410-1254 | 2019-11-21 |
| 1679118921 | Meredith Larson | Counselor | 5301 Kyler Ave Ne Ste 101, Albertville, MN 55301-4718 | 2019-11-11 |
| 1689217226 | Diane Sparish | Counselor | 7835 Main St N Ste 220, Maple Grove, MN 55369-7072 | 2019-10-28 |
| 1346883501 | Christine Lee Garwick-foley | Counselor | 10032 Quebec Ave S, Bloomington, MN 55438-2126 | 2019-10-21 |
| 1225687999 | Rebecca A Kreger | Counselor | 902 E 2nd St Ste 260, Winona, MN 55987-2640 | 2019-09-05 |
| 1790332195 | Esther Swen | Counselor | 2827 Newton Ave N, Minneapolis, MN 55411-1142 | 2019-08-20 |
| Find all providers with the same taxonomy | ||||
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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.