Individual provider Active NPI

Rafael Muir Cohen, M.A.

  • Mental Health Counselor
  • Saint Paul, MN
National Provider Identifier
1073893145
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CC01349 Issued in MN
Practice address
821 Raymond Ave Ste 240
Saint Paul, MN 55114-1525
Phone
(917) 697-3462
NPI assigned
Aug 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Art Therapist 221700000X 001237 NY
Mental Health Counselor 101YM0800X CC01349 MN Primary

Addresses

Primary practice location

821 Raymond Ave Ste 240
Saint Paul, MN 55114-1525

Mailing address

821 Raymond Ave Ste 240
Saint Paul, MN 55114-1525
Phone (917) 697-3462

Other practice location 1

4208 Park Glen Rd
Minneapolis, MN 55416-4758
Phone (763) 200-1441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241202002894 MN Practitioner - Mental Health Counselor 5799219895 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CC01349MNMDMental Health Counselor
1349MNMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Rebus Psychoanalysis, LLC Mental Health CurrentSince Sep 15, 2024 Accepting new patients
CGC LLC CurrentSince Oct 1, 2024 Accepting new patients

Locations

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

821 Raymond Ave
Ste 240
Saint Paul, MN 55114
Phone (612) 208-6594

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

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": "1313971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1073893145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 RAYMOND AVE STE 240",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141525",
            "telephone_number": "917-697-3462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 RAYMOND AVE STE 240",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141525",
            "telephone_number": "917-697-3462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4208 Park Glen Rd",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554164758",
            "country_code": "US",
            "telephone_number": "763-200-1441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COHEN",
        "first_name": "RAFAEL",
        "middle_name": "MUIR",
        "name_prefix": "Mr.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-22",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "NY",
            "license": "001237",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC01349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.