Individual provider Active NPI

Emmanuel Oppong

  • Mental Health Counselor
  • Saint Cloud, MN
National Provider Identifier
1023605664
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
22 Wilson Ave NE Ste 209
Saint Cloud, MN 56304-0440
Phone
(320) 237-6996
NPI assigned
Dec 29, 2020
Last updated
Dec 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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 NU Primary

Addresses

Primary practice location

22 Wilson Ave NE Ste 209
Saint Cloud, MN 56304-0440

Mailing address

PO Box 2041
Saint Cloud, MN 56302-2041

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
I20240411002562 MN Practitioner - Mental Health Counselor 2264871185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Cloud HospitalGroup PAC ID 4880594779, 215 clinicians

Practice addresses (Care Compare)

1406 6TH Ave N
Saint Cloud, MN 56303-1900
Phone (320) 251-2700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1176MNMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Cloud Hospital Current Accepting new patients
St. Cloud Hospital CurrentSince Mar 2, 2024 Accepting new patients
St. Cloud Hospital CurrentSince Mar 2, 2024 Accepting new patients

Locations

1406 6th Ave N
Saint Cloud, MN 56303
Phone (320) 255-5657

110 2nd St S
Ste 104
Waite Park, MN 56387
Phone (320) 259-9375

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1609200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1023605664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2041",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563022041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 WILSON AVE NE STE 209",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563040440",
            "telephone_number": "320-237-6996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPPONG",
        "first_name": "EMMANUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-29",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.