Individual provider Active NPI

Rose Maura Uchenna Okongwu, LPCC

  • Mental Health Counselor
  • Champlin, MN
National Provider Identifier
1023984838
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CC04764 Issued in MN
Practice address
11520 Preserve LN N
Champlin, MN 55316-1970
Phone
(651) 422-8130
Fax
(651) 348-8349
NPI assigned
Oct 17, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

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 CC04764 MN Primary

Addresses

Primary practice location

11520 Preserve LN N
Champlin, MN 55316-1970

Mailing address

11520 Preserve LN N
Champlin, MN 55316-1970
Phone (651) 422-8130

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

LicenseStateTypeSpecialty
CC04764MNMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1760659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1023984838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11520 PRESERVE LN N",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "553161970",
            "telephone_number": "651-422-8130",
            "fax_number": "651-348-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11520 PRESERVE LN N",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "553161970",
            "telephone_number": "651-422-8130",
            "fax_number": "651-348-8349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKONGWU",
        "first_name": "ROSE MAURA",
        "middle_name": "UCHENNA",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-17",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC04764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champlin, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.