Individual provider Active NPI

Elizabeth Stolt, LPCC, LADC

  • Mental Health Counselor
  • Vadnais Heights, MN
National Provider Identifier
1083112700
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
01994 Issued in MN
Practice address
3640 Talmage Cir Ste 216
Vadnais Heights, MN 55110-7100
Phone
(952) 413-5330
Fax
(952) 431-5334
NPI assigned
Jan 29, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2021

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) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 304258 MN
Mental Health Counselor 101YM0800X 01994 MN Primary

Addresses

Primary practice location

3640 Talmage Cir Ste 216
Vadnais Heights, MN 55110-7100

Mailing address

6636 Sheridan Ave S
Richfield, MN 55423-2050
Phone (612) 720-4653

Other practice location 1

332 Minnesota St Ste W1260
Saint Paul, MN 55101-1330
Phone (651) 348-7611

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

State licenses

LicenseStateTypeSpecialty
304258MNMDAddiction (Substance Use Disorder) Counselor
01994MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Danielle Golden, Crna, PA Multi-Specialty CurrentSince Jun 22, 2021 Accepting new patients
Asset Clinic Past Accepting new patients

Locations

3640 Talmage Cir
Ste 216
Vadnais Hts, MN 55110
Phone (651) 379-4006

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": "1517184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1083112700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6636 SHERIDAN AVE S",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232050",
            "telephone_number": "612-720-4653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 TALMAGE CIR STE 216",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551107100",
            "telephone_number": "952-413-5330",
            "fax_number": "952-431-5334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "332 Minnesota St Ste W1260",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551011330",
            "country_code": "US",
            "telephone_number": "651-348-7611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOLT",
        "first_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "LPCC, LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-29",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "304258",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "01994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vadnais Heights, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.