Taylor Degen
Individual provider Active NPI Mental Health Counselor · Shoreview, MN
NPI 1013560127 · NPPES record last updated Aug 26, 2021
Key facts
- NPI
- 1013560127
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 3550 Lexington Ave N Ste 100
Shoreview, MN 55126-8048 - Phone
- (651) 583-5565
- NPI assigned
- Jul 17, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250314002999 | MN | Practitioner - Mental Health Counselor | 7012439466 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3012 | MN | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Support Services Inc. | Mental Health | Current |
Accepting new patients |
| Nystrom & Associates, LTD | Current |
Accepting new patients | |
| Arden Shores Counseling | Mental Health | Past |
Accepting new patients |
Locations
1856 Beam Ave
#200
Maplewood, MN 55109
Phone (651) 661-6550
1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718
1715 Tower Dr W
Ste 100
Stillwater, MN 55082
Phone (651) 275-4180
1811 Weir Dr
Ste 270
Woodbury, MN 55125
Phone (651) 243-6087
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
3550 Lexington Ave N Ste 100
Shoreview, MN 55126-8048
Mailing address
3550 Lexington Ave N Ste 100
Shoreview, MN 55126-8048
Other practice location 1
1811 Weir Dr Ste 270
Woodbury, MN 55125-6741
Phone (651) 714-9646
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tdegen@nystromcounseling.com | Health Information Exchange (HIE) | |
| Direct Messaging Address | tdegen@ardenshoresmn.com | Health Information Exchange (HIE) | Arden Shores Counseling |
Other providers in Shoreview, MN
- Critical Care Services, Inc
- Crossroads: Solutions for Life LLC
- Caitlin Marie Dado
- Sydney Christine Daley
- Temitope Abiola Dawodu
- Debbie Lynn Deloye
- Edward Martel Dennison
- Elizabeth A Detlie
- Liban Dima
- Larissa M Dimitrov
All providers in Shoreview, MN · Mental Health Counselor in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.