Individual provider Active NPI

Lindsey Mackereth, M.A, L.P.C., L.A.D.C

  • Professional Counselor
  • Edina, MN
National Provider Identifier
1063889616
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
01501 Issued in MN
Practice address
7117 Ohms LN
Edina, MN 55439
Phone
(651) 505-3456
NPI assigned
Aug 31, 2015
Last updated
Aug 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
304109MNMDAddiction (Substance Use Disorder) Counselor
01501MNMDProfessional 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.

Verify at the official NPI Registry.