Individual provider Active NPI

Elizabeth Kaye Dumke, MS, LPCC, ATR

  • Mental Health Counselor
  • Edina, MN
National Provider Identifier
1013637693
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3495 Issued in MN
Practice address
4820 W 77TH St Ste 130
Edina, MN 55435-4832
Phone
(651) 313-8080
Fax
(651) 925-0610
NPI assigned
Sep 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 3495 MN Primary

Addresses

Primary practice location

4820 W 77TH St Ste 130
Edina, MN 55435-4832

Mailing address

1370 Mendota Heights Rd
Mendota Heights, MN 55120-1281
Phone (651) 313-8080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240119003334 MN Practitioner - Mental Health Counselor 3274985759 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3495MNMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates, LTD CurrentSince Apr 13, 2026 Accepting new patients

Locations

4820 77th St W
Ste 130
Edina, MN 55435
Phone (320) 591-3559

1370 Mendota Heights Rd
Mendota Heights, MN 55120
Phone (651) 583-4447

1150 Montreal Ave
Ste 107
Saint Paul, MN 55116
Phone (651) 303-8080

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1013637693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 MENDOTA HEIGHTS RD",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551201281",
            "telephone_number": "651-313-8080",
            "fax_number": "651-925-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4820 W 77TH ST STE 130",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354832",
            "telephone_number": "651-313-8080",
            "fax_number": "651-925-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUMKE",
        "first_name": "ELIZABETH",
        "middle_name": "KAYE",
        "credential": "MS, LPCC, ATR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-01",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "3495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.