MS. CARISSA MEHITABEL KAUFMAN MA, LMFT - NPI 1922651090 - Marriage & Family Therapist in Plymouth, MN

Q: What is Carissa Kaufman's NPI number?

The NPI number for Carissa Kaufman is 1922651090. It was assigned to this individual provider in the NPPES registry on July 18, 2019.

Q: What is Carissa Kaufman's specialty?

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

Q: Is Carissa Kaufman enrolled in Medicare?

No. Carissa Kaufman has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Carissa Kaufman was last updated on December 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

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About Ms. Carissa Mehitabel Kaufman Ma, Lmft NPPES

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

MS. CARISSA MEHITABEL KAUFMAN MA, LMFT (NPI 1922651090) is an individual marriage & family therapist in Plymouth, Minnesota, licensed in Minnesota (3236) and active in the NPI registry since July 2019. She has opted out of Medicare through January 1, 2028.

NPPES Registry Identity

NPI1922651090

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameMS. CARISSA MEHITABEL KAUFMANCredential: MA, LMFT

Location Address9800 SHELARD PKWY STE 115Plymouth, MN 55441-6411

Mailing Address9800 Shelard Pkwy Ste 115Plymouth, MN 55441-6411 · (612) 547-8554 · Fax (763) 432-6001

Phone(612) 547-8554

Fax(763) 432-6001

Sole ProprietorNo

Enumeration DateJuly 18, 2019

Last NPPES UpdateDecember 29, 20212 updates tracked since enumeration

NPPES CertifiedDecember 29, 2021

✔ NPI 1922651090 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in MN · 3236

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.

9800 SHELARD PKWY STE 115, Plymouth, MN 55441

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Ms. Carissa Mehitabel Kaufman Ma, Lmft has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2024 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2024

Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 13

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

KAYLIE BROBERG

Marriage & Family Therapist