Active NPI
Nicole Pierce-Risvold
- Mental Health Counselor
- Minneapolis, MN
National Provider Identifier
1013533595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 2300
- Practice address
- 401 N 3Rd St Ste 220
Minneapolis, MN 55401-1349 - Phone
- (218) 851-4416
- NPI assigned
- Jun 22, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 2300 | MN | Primary |
Addresses
Primary practice location
401 N 3Rd St Ste 220
Minneapolis, MN 55401-1349
Mailing address
4150 Nokomis Ave
Minneapolis, MN 55406-3146
Phone (218) 851-4416
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2300 | MN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592784000000",
"number": "1013533595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4150 NOKOMIS AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554063146",
"telephone_number": "218-851-4416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 N 3RD ST STE 220",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554011349",
"telephone_number": "218-851-4416"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIERCE-RISVOLD",
"first_name": "NICOLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-22",
"last_updated": "2020-06-22",
"certification_date": "2020-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MN",
"license": "2300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.