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

Samuel Secord

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1093324022

Samuel Secord is a Student in an Organized Health Care Education/Training Program in Burnsville, Minnesota. Licensed in Minnesota. Registered with an NPI since 2020.

Licensed in
MN
In the registry since
2020
Specialties on file
2

Practice location Address checks out

11990 Portland Ave
Burnsville, MN 55337-1516
Phone: (763) 310-6882
Show map & directions

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

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X · Licence 4474 (MN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1093324022
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 27, 2020
Last updated in NPPESAugust 6, 2025
Certification dateAugust 6, 2025
Mailing address11990 Portland Ave, Burnsville, MN 55337-1516

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