Active NPI
Tiffany Rose Allen, MA, LMFT
- Mental Health Counselor
- Bloomington, MN
National Provider Identifier
1104545151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 8120 Penn Ave S
Bloomington, MN 55431-1358 - Phone
- (612) 965-2545
- NPI assigned
- Aug 23, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
8120 Penn Ave S
Bloomington, MN 55431-1358
Mailing address
11975 Portland Ave Ste 130
Burnsville, MN 55337-1589
Phone (612) 965-2545
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101YM0800X | Medicaid | MN |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250106003074 | MN | Practitioner - Marriage and Family Therapist | 3678001591 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Serenity Behavioral Health & Wellness LLC | Current | Accepting new patients |
Locations
6375 W 143rd St
Savage, MN 55378
Phone (952) 592-2200
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": "1661212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770595200000",
"number": "1104545151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11975 PORTLAND AVE STE 130",
"city": "BURNSVILLE",
"state": "MN",
"postal_code": "553371589",
"telephone_number": "612-965-2545"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8120 PENN AVE S",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554311358",
"telephone_number": "612-965-2545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "TIFFANY",
"middle_name": "ROSE",
"credential": "MA, LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-23",
"last_updated": "2026-02-09",
"certification_date": "2026-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101YM0800X",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bloomington, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.