Individual provider Active NPI

Theresa Marie Voss, M.A., L.P.

  • Counseling Psychologist
  • Saint Paul, MN
National Provider Identifier
1093936379
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
LP1178 Issued in MN
Practice address
821 Raymond Ave Ste 100
Saint Paul, MN 55114-1525
Phone
(651) 251-0369
Fax
(651) 251-3072
NPI assigned
May 2, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X LP1178 MN Primary

Addresses

Primary practice location

821 Raymond Ave Ste 100
Saint Paul, MN 55114-1525

Mailing address

5415 Columbus Ave
Minneapolis, MN 55417-2432
Phone (612) 823-1203

Other identifiers 4

IdentifierTypeStateIssuer
6263293OtherMNMEDICA
104441OtherMNPREFERRED ONE
104441OtherMNUCARE
3H758VO AND 3H757VOOtherMNBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050422000239 MN Practitioner - Psychologist Billing Independently 2163460833 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP1178MNMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lyn-Lake Psychotherapy and Wellness LTD. CurrentSince May 24, 2024 Accepting new patients
Susan Eckfeldt Past Accepting new patients

Locations

2900 Thomas Ave S
Ste 100
Minneapolis, MN 55416

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1093936379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5415 COLUMBUS AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172432",
            "telephone_number": "612-823-1203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 RAYMOND AVE STE 100",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141525",
            "telephone_number": "651-251-0369",
            "fax_number": "651-251-3072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOSS",
        "first_name": "THERESA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "M.A., L.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "LP1178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "6263293",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "104441",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "104441",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3H758VO AND 3H757VO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.