MARY BAUER, MA, LADC, MFT Intern — NPI 1033529664 (Licensed & Credentialed Psychoanalyst in JORDAN, MN)

CMS-1500 Box 24J / 33a • NPI

1033529664

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

102L00000X

Licensed & Credentialed Psychoanalyst

Box 32 Service Location & ZIP+4

110 1ST ST E STE 102, JORDAN, MN, 55352-1502

✓ 9-Digit EDI 837 ZIP+4 (55352-1502)

Practice Phone & Referral Fax

(651) 356-5234

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1033529664 (MARY BAUER, MA, LADC, MFT Intern) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1033529664` (NPI-1 Individual Practitioner)
Provider / Legal Name	MARY BAUER, MA, LADC, MFT Intern
Plain-English Specialty	Licensed & Credentialed Psychoanalyst NUCC Code: `102L00000X` (Psychoanalyst)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	110 1ST ST E STE 102, JORDAN, MN, 55352-1502
Practice Telephone / Fax	Tel: (651) 356-5234
Administrative Mailing Address	7997 147TH ST W, APPLE VALLEY, MN, 55124-6347
Enumeration & Last Sync	Enumerated: 2014-05-05 \| CMS Record Updated: 2020-01-22

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

110 1ST ST E STE 102, JORDAN, MN, 55352-1502

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Plain-English Taxonomy & CMS Crosswalk (102L00000X)

What Does Taxonomy Code 102L00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 102L00000X translates to:
"Licensed & Credentialed Psychoanalyst"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Psychoanalyst for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (MARY BAUER, MA, LADC, MFT Intern)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`102L00000X` — Psychoanalyst Plain English: Licensed & Credentialed Psychoanalyst	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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MARY BAUER, MA, LADC, MFT Intern (NPI #1033529664)