FAMILY BASED THERAPY ASSOCIATES
NPI 1194762005
Counselor - Mental Health in Coon Rapids, MN
About Family Based Therapy Associates NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FAMILY BASED THERAPY ASSOCIATES (NPI 1194762005) is a healthcare organization registered as a mental health in Coon Rapids, Minnesota and active in the NPI registry since May 2006. The organization lists Randall D Wallace, Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Family Based Therapy Associates is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
22Medicare enrollment records show 22 clinicians reassign Medicare billing to Family Based Therapy Associates, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 6 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 5
Nearest to this location (20)
See all 22Coon Rapids, MN 55433
Coon Rapids, MN 55433
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Family Based Therapy Associates's NPI number?
The NPI number for Family Based Therapy Associates is 1194762005. It was assigned to this organization in the NPPES registry on May 31, 2006.
Where is Family Based Therapy Associates located?
Family Based Therapy Associates is located at 199 Coon Rapids Blvd NW Suite 306, Coon Rapids, MN 55433. The listed phone number is (763) 780-1520.
What is Family Based Therapy Associates's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Family Based Therapy Associates enrolled in Medicare?
Yes. Family Based Therapy Associates is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Family Based Therapy Associates?
According to the CMS Revalidation Reassignment List (October 2026 release), 22 clinicians in 5 Medicare specialties reassign their Medicare billing to Family Based Therapy Associates. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Social Worker (9), Marriage and Family Therapist (8) and Clinical Psychologist (3). Of these, 3 practice at this address and 6 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Family Based Therapy Associates accept?
Health plans from HealthPartners list Family Based Therapy Associates 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 Family Based Therapy Associates was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.
# Family Based Therapy Associates · NPI 1194762005
Mental Health organization in Coon Rapids, Minnesota. Organization record, active in the CMS NPPES registry since May 31, 2006.
## Identity
- **NPI:** 1194762005 (Entity type: Organization)
- **Enumerated:** May 31, 2006
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **Organization subpart:** No
- **Authorized official:** Randall Wallace, DIRECTOR
## Practice location
- **Address:** 199 COON RAPIDS BLVD NW, SUITE 306, Coon Rapids, MN 55433-5831
- **Phone:** (763) 780-1520 · **Fax:** (763) 780-2114
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 22 clinicians in 5 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Clinical Social Worker (9), Marriage and Family Therapist (8), Clinical Psychologist (3); 3 practice at this address and 6 within 10 miles; [full list](https://npiprofile.com/npi/1194762005/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 22, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1194762005) · Data from the CMS NPPES public registry.