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

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: July 26, 2026.

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

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 and is a graduate of Other (2021).

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
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
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.

11990 PORTLAND AVE, Burnsville, MN 55337

Accepted 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).

PECOS PAC ID4688188238
PECOS Enrollment IDI20250708000366
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.

Clinic/Center (Adult Mental Health)
11990 PORTLAND AVE
BURNSVILLE, MN 55337
Marriage & Family Therapist
11990 PORTLAND AVE
BURNSVILLE, MN 55337
Counselor (Mental Health)
11990 PORTLAND AVE
BURNSVILLE, MN 55337
Art Therapist
11990 PORTLAND AVE
BURNSVILLE, MN 55337
Marriage & Family Therapist
11990 PORTLAND AVE
BURNSVILLE, MN 55337
Psychologist
11990 PORTLAND AVE
BURNSVILLE, MN 55337
Marriage & Family Therapist
11990 PORTLAND AVE
BURNSVILLE, MN 55337
Marriage & Family Therapist
11990 PORTLAND AVE
BURNSVILLE, MN 55337

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

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.

Where is Samuel Secord located?

Samuel Secord practices at 11990 Portland Ave, Burnsville, MN 55337. The listed phone number is (763) 310-6882.

What is Samuel Secord's specialty?

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

Is Samuel Secord enrolled in Medicare?

Yes. Samuel Secord is registered in the Medicare PECOS enrollment system.

What insurance does Samuel Secord accept?

Health plans from HealthPartners list Samuel Secord as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Samuel Secord was last updated on August 6, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.