Individual provider Active NPI

Rileigh Nicole Coyle, MA, LPCC

  • Mental Health Counselor
  • Minneapolis, MN
National Provider Identifier
1093395170
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4061 Issued in MN
Practice address
3112 Hennepin Ave
Minneapolis, MN 55408-2619
Phone
(612) 682-1199
Fax
(800) 507-1086
NPI assigned
Apr 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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 4061 MN Primary

Addresses

Primary practice location

3112 Hennepin Ave
Minneapolis, MN 55408-2619

Mailing address

3112 Hennepin Ave
Minneapolis, MN 55408-2619
Phone (612) 682-1199

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
I20240126000116 MN Practitioner - Mental Health Counselor 1052764081 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Lyn-Lake Psychotherapy and Wellness LTDGroup PAC ID 9638581291, 72 clinicians

Practice addresses (Care Compare)

621 W Lake St
Suite 350
Minneapolis, MN 55408-2952
Phone (612) 979-2276

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lyn-Lake Psychotherapy and Wellness LTD. Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Lorenz Clinic, LLC PastSince Apr 1, 2021 Accepting new patients

Locations

3112 Hennepin Ave
Minneapolis, MN 55408
Phone (612) 293-8814

2900 Thomas Ave S
Ste 100
Minneapolis, MN 55416

621 W Lake St
Ste 350
Minneapolis, MN 55408
Phone (612) 547-9990

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16506/brand/1/csg/1/fhir/r4

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": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1093395170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3112 HENNEPIN AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082619",
            "telephone_number": "612-682-1199",
            "fax_number": "800-507-1086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3112 HENNEPIN AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082619",
            "telephone_number": "612-682-1199",
            "fax_number": "800-507-1086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COYLE",
        "first_name": "RILEIGH",
        "middle_name": "NICOLE",
        "credential": "MA, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-12",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "4061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.