1. Home
  2. Directory
  3. Minnesota
  4. Champlin
  5. Marriage Family Therapist
  6. NPI Profile

BEACON THERAPY ASSOCIATES, PC
NPI 1407084031
Marriage & Family Therapist in Champlin, MN

Active since June 22, 2009
11141 ZEALAND AVE N, CHAMPLIN, MN 55316(763) 951-3091(763) 951-3097 Get Directions Write a Review

NPPES record last updated: May 18, 2018. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Beacon Therapy Associates, Pc NPPES

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

BEACON THERAPY ASSOCIATES, PC (NPI 1407084031) is a healthcare organization registered as a marriage & family therapist in Champlin, Minnesota and active in the NPI registry since June 2009. The organization maintains 5 additional practice locations and lists Shelly Marie Davenport, President/therapist, as its authorized official.

NPPES Registry Identity

NPI1407084031
Entity TypeOrganization
Primary Taxonomy106H00000X
Legal Business NameBEACON THERAPY ASSOCIATES, PC
Location Address11141 ZEALAND AVE NChamplin, MN 55316
Mailing Address11141 Zealand Ave NChamplin, MN 55316-3595 · (763) 951-3091 · Fax (763) 951-3097
Phone(763) 951-3091
Fax(763) 951-3097
Organization SubpartNo
Authorized OfficialShelly Marie DavenportPresident/therapist · (763) 528-5235
Enumeration DateJune 22, 2009
Last NPPES UpdateMay 18, 2018
✔ NPI 1407084031 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
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 ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X
Also ListedCounselor · ProfessionalTaxonomy 101YP2500X
Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X
Also ListedRegistered Nurse · Psychiatric/Mental Health, Child & AdolescentTaxonomy 163WP0807X
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
11141 ZEALAND AVE N, Champlin, MN 55316
Open in Google Maps ↗

Secondary Practice Locations 5

Location 1299 Coon Rapids Blvd NWCoon Rapids, MN 55433-5832 · Phone (763) 951-3091 · Fax (763) 951-3097
Location 2700 Twelve Oaks Center DrWayzata, MN 55391-4401 · Phone (763) 951-3091 · Fax (763) 951-3097
Location 34501 Allendale DrSaint Paul, MN 55127-6349 · Phone (763) 951-3091 · Fax (763) 951-3097
Location 4543 Coon Rapids Blvd NWCoon Rapids, MN 55433-5500 · Phone (763) 951-3091 · Fax (763) 951-3097
Location 53101 Old Highway 8Roseville, MN 55113-1072 · Phone (763) 951-3091 · Fax (763) 951-3097

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

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

Beacon Therapy Associates, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

8

Medicare enrollment records show 8 clinicians reassign Medicare billing to Beacon Therapy Associates, PC, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 6 within 10 miles. They are listed nearest first.

Clinicians, nearest first (8)

Loren Bergstedt, LPC, LADC
Mental Health Counselor
NPI 1538570726
11141 ZEALAND AVE N
Champlin, MN 55316
(651) 769-7607
✔ PECOS✔ Accepts MedicareSame address
Amy Bianchi-Rossi, LPCC
Mental Health Counselor
NPI 1679815997
11141 ZEALAND AVE N
Champlin, MN 55316
(763) 670-6050
✔ PECOS✔ Accepts MedicareSame address
Jan D'ambrosio, MA, LMFT
Marriage and Family Therapist
NPI 1538625256
11141 ZEALAND AVE N
Champlin, MN 55316
(763) 951-3091
✔ PECOS✔ Accepts MedicareSame address
Shelly Davenport, MS, LMFT
Marriage and Family Therapist
NPI 1134166275
11141 ZEALAND AVE N
Champlin, MN 55316
(763) 951-3091
✔ PECOS✔ Accepts MedicareSame address
Christopher Emery, MSW, LICSW
Clinical Social Worker
NPI 1477693851
11141 ZEALAND AVE N
Champlin, MN 55316
(763) 442-8101
✔ PECOSSame address
Krista Hultgren, GNP
Nurse Practitioner
NPI 1699752535
5200 DOUGLAS DR N
Crystal, MN 55429
(888) 290-1209
✔ PECOS✔ Accepts Medicare7.6 mi
Jeanne Ketola, MA LPCC
Mental Health Counselor
NPI 1366822074
8800 HIGHWAY 7 SUITE 200
Minneapolis, MN 55426
(952) 562-5733
✔ PECOS✔ Accepts Medicare14 mi
Nancy Dorman, LAMFT
Marriage and Family Therapist
NPI 1447594221
4501 ALLENDALE DR
Saint Paul, MN 55127
(651) 653-0387
✔ PECOS✔ Accepts Medicare17 mi

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 Beacon Therapy Associates, PC's NPI number?

The NPI number for Beacon Therapy Associates, PC is 1407084031. It was assigned to this organization in the NPPES registry on June 22, 2009.

Where is Beacon Therapy Associates, PC located?

Beacon Therapy Associates, PC is located at 11141 Zealand Ave N, Champlin, MN 55316. The listed phone number is (763) 951-3091.

What is Beacon Therapy Associates, PC's specialty?

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

Is Beacon Therapy Associates, PC enrolled in Medicare?

Yes. Beacon Therapy Associates, PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Beacon Therapy Associates, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians in 4 Medicare specialties reassign their Medicare billing to Beacon Therapy Associates, PC. 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 Marriage and Family Therapist (3), Mental Health Counselor (3) and Clinical Social Worker (1). Of these, 5 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 Beacon Therapy Associates, PC accept?

Health plans from HealthPartners list Beacon Therapy Associates, PC 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 Beacon Therapy Associates, PC was last updated on May 18, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.