Active NPI
Lindsey Mackereth, M.A, L.P.C., L.A.D.C
- Professional Counselor
- Edina, MN
National Provider Identifier
1063889616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 01501
- Practice address
- 7117 Ohms LN
Edina, MN 55439 - Phone
- (651) 505-3456
- NPI assigned
- Aug 31, 2015
- Last updated
- Aug 13, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 304109 | MN | |
| Professional Counselor | 101YP2500X | 01501 | MN | Primary |
Addresses
Primary practice location
7117 Ohms LN
Edina, MN 55439
Mailing address
1741 Glenview Ave
Arden Hills, MN 55112-2817
Phone (651) 505-3456
Other practice location 1
7200 Forestview Lane N
Maple Grove, MN 55369-2817
Phone (651) 505-3456
Other practice location 2
1741 Glenview Ave
Arden Hills, MN 55112-2817
Phone (651) 505-3456
Other practice location 3
7200 Forestview Lane N
Maple Grove, MN 55369-2817
Phone (651) 505-3456
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 304109 | MN | MD | Addiction (Substance Use Disorder) Counselor |
| 01501 | MN | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565654400000",
"number": "1063889616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1741 GLENVIEW AVE",
"city": "ARDEN HILLS",
"state": "MN",
"postal_code": "551122817",
"telephone_number": "651-505-3456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7117 OHMS LN",
"city": "EDINA",
"state": "MN",
"postal_code": "55439",
"telephone_number": "651-505-3456"
}
],
"practiceLocations": [
{
"address_1": "7200 Forestview Lane N",
"address_purpose": "LOCATION",
"city": "Maple Grove",
"state": "MN",
"postal_code": "553692817",
"country_code": "US",
"telephone_number": "651-505-3456",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1741 Glenview Ave",
"address_purpose": "LOCATION",
"city": "Arden Hills",
"state": "MN",
"postal_code": "551122817",
"country_code": "US",
"telephone_number": "651-505-3456",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7200 Forestview Lane N",
"address_purpose": "LOCATION",
"city": "Maple Grove",
"state": "MN",
"postal_code": "553692817",
"country_code": "US",
"telephone_number": "651-505-3456",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MACKERETH",
"first_name": "LINDSEY",
"credential": "M.A, L.P.C., L.A.D.C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-31",
"last_updated": "2019-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MN",
"license": "304109",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MN",
"license": "01501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Edina, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.