Individual provider Active NPI

Lindsay Lillstrom

  • Mental Health Counselor
  • Minneapolis, MN
National Provider Identifier
1063936144
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
321 W 48TH St
Minneapolis, MN 55419-5417
Phone
(541) 801-3413
NPI assigned
Jul 31, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 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 Primary

Addresses

Primary practice location

321 W 48TH St
Minneapolis, MN 55419-5417

Mailing address

11606 Minnetonka Mills Rd
Hopkins, MN 55305-5158
Phone (541) 801-3413

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jun 23, 2025 through Jun 23, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wavelengths NW LLC CurrentSince Jun 3, 2025 Accepting new patients
Morrison Child and Family Services PastSince Jul 1, 2022 Accepting new patients

Locations

321 W 48th St
Minneapolis, MN 55419
Phone (206) 484-6566

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1063936144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11606 MINNETONKA MILLS RD",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553055158",
            "telephone_number": "541-801-3413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 W 48TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554195417",
            "telephone_number": "541-801-3413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLSTROM",
        "first_name": "LINDSAY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-31",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.