Individual provider Active NPI

Scott C Washburn, LADC

  • Addiction (Substance Use Disorder) Counselor
  • Minnetonka, MN
National Provider Identifier
1093856502
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
301189 Issued in MN
Practice address
15320 Minnetonka Blvd #200
Minnetonka, MN 55345
Phone
(952) 932-7277
Fax
(952) 932-9827
NPI assigned
Feb 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 301189 MN Primary

Addresses

Primary practice location

15320 Minnetonka Blvd #200
Minnetonka, MN 55345

Mailing address

15320 Minnetonka Blvd #200
Minnetonka, MN 55345
Phone (952) 932-7277

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
I20260311002920 MN Practitioner - Mental Health Counselor 7911480561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Soul Work Counseling, LLCGroup PAC ID 4789910233, 12 clinicians

Practice addresses (Care Compare)

11188 Zealand Ave N
Champlin, MN 55316-3594
Phone (763) 746-0842

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
301189MNMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Soul Work Counseling, LLC CurrentSince Feb 13, 2026 Accepting new patients

Locations

11188 Zealand Ave N
Champlin, MN 55316
Phone 7637460842 ext. 1

11925 Highway 65 NE
Minneapolis, MN 55434
Phone (763) 746-0842

1001 Twelve Oaks Center Dr
Ste 1030B
Wayzata, MN 55391

Organizations & group practices 1

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": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093856502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15320 MINNETONKA BLVD #200",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "55345",
            "telephone_number": "952-932-7277",
            "fax_number": "952-932-9827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15320 MINNETONKA BLVD #200",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "55345",
            "telephone_number": "952-932-7277",
            "fax_number": "952-932-9827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHBURN",
        "first_name": "SCOTT",
        "middle_name": "C",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "301189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

Verify at the official NPI Registry.