NPI
Family Based Therapy Associates
Phone (763) 780-1520 · Fax (763) 780-2114 · NPI 1194762005
Read from the NPPES registry on October 23, 2026.
Facts
- Status
- Active
- Type
- Organization
- Enumeration date
- 2006-05-31
- Last updated
- 2020-08-22
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Specialties
Licenses
The registry row did not include a license.
Location
- Practice location
- 199 Coon Rapids Blvd NW, Suite 306
- City
- Coon Rapids MN
- Postal code
- 55433-5831
- Phone
- (763) 780-1520
- Fax
- (763) 780-2114
Organization contact
- Name
- Randall Wallace
- Title
- Director
- Phone
- (763) 780-1520
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. Confirm on OIG's online search.
Nearby
Mental Health Counselors in Coon Rapids, MN. 68 with this primary taxonomy in the public file.
Other NPIs in Coon Rapids, MN. 2,174 records in the public file.
Public data from NPPES and CMS. Not a credentialing determination.
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