Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Family Based Therapy Associates

Organization Mental Health Counselor · NPI 1194762005

Family Based Therapy Associates is a Mental Health Counselor in Coon Rapids, Minnesota. Registered with an NPI since 2006.

In the registry since
2006

Practice location Address checks out

199 Coon Rapids Blvd NW Ste 306
Coon Rapids, MN 55433-5831
Phone: (763) 780-1520
Fax: (763) 780-2114
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X

Record details

NPI number1194762005
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Randall Wallace — Director · (763) 780-1520
NPI enumeratedMay 31, 2006
Last updated in NPPESAugust 22, 2020
Mailing address199 Coon Rapids Blvd Nw, Suite 306, Coon Rapids, MN 55433-5831

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