Active NPI
Michael Anthony Branchaud, LPC
- Professional Counselor
- Roseville, MN
National Provider Identifier
1104134410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC00950
- Practice address
- 2489 Rice St
Suite 90
Roseville, MN 55113-3738 - Phone
- (651) 528-7550
- NPI assigned
- Sep 21, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC00950 | MN | Primary |
Addresses
Primary practice location
2489 Rice St
Suite 90
Roseville, MN 55113-3738
Mailing address
15182 Farnham Ave N
Hugo, MN 55038-6306
Phone (763) 221-8834
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
| License | State | Type | Specialty |
|---|---|---|---|
| LPC00950 | MN | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285027200000",
"number": "1104134410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15182 FARNHAM AVE N",
"city": "HUGO",
"state": "MN",
"postal_code": "550386306",
"telephone_number": "763-221-8834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2489 RICE ST",
"address_2": "SUITE 90",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "551133738",
"telephone_number": "651-528-7550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANCHAUD",
"first_name": "MICHAEL",
"middle_name": "ANTHONY",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-09-21",
"last_updated": "2010-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MN",
"license": "LPC00950",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.