SAMUEL SECORD
NPI 1093324022
Marriage & Family Therapist in Burnsville, MN

Q: What is Samuel Secord's NPI number?

The NPI number for Samuel Secord is 1093324022. It was assigned to this individual provider in the NPPES registry on July 27, 2020.

Q: What is Samuel Secord's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Q: When was this NPI record last updated?

The NPPES record for Samuel Secord was last updated on August 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 27, 2020PECOS Enrolled

11990 PORTLAND AVE, BURNSVILLE, MN 55337(763) 310-6882 Get Directions Write a Review

NPPES record last updated: August 6, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 6, 2025, Jul 27, 2020 (2 updates tracked since 2020).

On this page

About Samuel Secord NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMUEL SECORD (NPI 1093324022) is an individual marriage & family therapist in Burnsville, Minnesota, licensed in Minnesota (4474) and active in the NPI registry since July 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1093324022

Entity TypeIndividualMale

Primary Taxonomy106H00000X

Provider Legal NameSAMUEL SECORD

Location Address11990 PORTLAND AVEBurnsville, MN 55337-1516

Mailing Address11990 Portland AveBurnsville, MN 55337-1516 · (763) 310-6882

Phone(763) 310-6882

Sole ProprietorNo

Enumeration DateJuly 27, 2020

Last NPPES UpdateAugust 6, 20252 updates tracked since enumeration

NPPES CertifiedAugust 6, 2025

✔ NPI 1093324022 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in MN · 4474

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.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

11990 PORTLAND AVE, Burnsville, MN 55337

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samuel Secord is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ASHLEE SECORD MA LMFT

Clinic/Center (Adult Mental Health)