Individual provider Active NPI

Patricia Ann Schulte, LICSW

  • Mental Health Counselor
  • Minneapolis, MN
National Provider Identifier
1104423169
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
29287 Issued in MN
Practice address
2724 University Ave SE Ste B
Minneapolis, MN 55414-3210
Phone
(612) 299-1090
NPI assigned
Oct 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2020

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 29287 MN Primary

Addresses

Primary practice location

2724 University Ave SE Ste B
Minneapolis, MN 55414-3210

Mailing address

154 Thorne St
Walla Walla, WA 99362-3143
Phone (651) 226-2910

Other names 1

  • Tricia Schulte Other name

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
I20231016000556 MN Practitioner - Clinical Social Worker 1456706274 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lyn-Lake Psychotherapy and Wellness LTD. Mental Health CurrentSince Aug 2, 2023 Accepting new patients
Siskiwit Bay Counseling, PLLC PastSince Oct 4, 2020 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1104423169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 THORNE ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993623143",
            "telephone_number": "651-226-2910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2724 UNIVERSITY AVE SE STE B",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554143210",
            "telephone_number": "612-299-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTE",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-02",
        "last_updated": "2020-10-02",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "29287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRICIA",
            "last_name": "SCHULTE",
            "credential": "LICSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.