Individual provider Active NPI

Elizabeth Denio, MA

  • Mental Health Counselor
  • Minneapolis, MN
National Provider Identifier
1063115095
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
4208 Park Glen Rd
Minneapolis, MN 55416-4758
Phone
(612) 545-8158
NPI assigned
Mar 27, 2023
Last updated
Mar 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

4208 Park Glen Rd
Minneapolis, MN 55416-4758

Mailing address

6801 Blaisdell Ave
Richfield, MN 55423-2328
Phone (612) 545-8158

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3897MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CGC LLC CurrentSince Oct 1, 2024 Accepting new patients

Locations

333 Washington Ave N
Minneapolis, MN 55401
Phone (612) 349-2797

4208 Park Glen Rd
St Louis Park, MN 55416
Phone (612) 825-4792

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, 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": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1063115095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 BLAISDELL AVE",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232328",
            "telephone_number": "612-545-8158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4208 PARK GLEN RD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164758",
            "telephone_number": "612-545-8158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENIO",
        "first_name": "ELIZABETH",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.