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MELODIE ILLIES NPI 1952662611


NPI Information

NPI: 1952662611
Provider Name: MELODIE ILLIES
Classification: Marriage & Family Therapist - 106H00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
16201 90TH ST NE
SUITE 200
OTSEGO, MN
ZIP 55330
Phone: (763) 746-9492
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Melodie Illies is a marriage family therapist in Otsego, MN. The provider is 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. Melodie Illies NPI is 1952662611. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

16201 90TH ST NE
SUITE 200
OTSEGO, MN
ZIP 55330-463
Phone: (763) 746-9492

The NPI 1952662611 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 5/30/2012 and was last updated on 5/30/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1106H00000XMarriage & Family Therapist2447MINNESOTAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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