LAKESHORE FAMILY THERAPY LLC
NPI 1699179994
Marriage & Family Therapist in Wayzata, MN
About Lakeshore Family Therapy Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAKESHORE FAMILY THERAPY LLC (NPI 1699179994) is a healthcare organization registered as a marriage & family therapist in Wayzata, Minnesota and active in the NPI registry since October 2014. The organization lists Kelly Lee Rose, Owner, 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)
Lakeshore Family Therapy Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to Lakeshore Family Therapy LLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.
Clinicians, nearest first (5)
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 Lakeshore Family Therapy LLC's NPI number?
The NPI number for Lakeshore Family Therapy LLC is 1699179994. It was assigned to this organization in the NPPES registry on October 15, 2014.
Where is Lakeshore Family Therapy LLC located?
Lakeshore Family Therapy LLC is located at 3701 Shoreline Dr Ste 102A, Wayzata, MN 55391. The listed phone number is (651) 231-7471.
What is Lakeshore Family Therapy LLC's specialty?
The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.
Is Lakeshore Family Therapy LLC enrolled in Medicare?
Yes. Lakeshore Family Therapy LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Lakeshore Family Therapy LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians reassign their Medicare billing to Lakeshore Family Therapy LLC, in Clinical Social Worker, Marriage and Family Therapist and Mental Health Counselor. 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. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Lakeshore Family Therapy LLC accept?
Health plans from HealthPartners list Lakeshore Family Therapy LLC 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 Lakeshore Family Therapy LLC was last updated on May 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.
# Lakeshore Family Therapy Llc · NPI 1699179994
Marriage & Family Therapist organization in Wayzata, Minnesota. Organization record, active in the CMS NPPES registry since October 15, 2014.
## Identity
- **NPI:** 1699179994 (Entity type: Organization)
- **Enumerated:** October 15, 2014
- **Primary specialty:** Marriage & Family Therapist · taxonomy 106H00000X
- **Organization subpart:** No
- **Authorized official:** Kelly Rose, OWNER
## Practice location
- **Address:** 3701 SHORELINE DR STE 102A, Wayzata, MN 55391-4000
- **Phone:** (651) 231-7471
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 5 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Marriage and Family Therapist (2), Mental Health Counselor (2), Clinical Social Worker (1); 3 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 19, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1699179994) · Data from the CMS NPPES public registry.