Active NPI
Faith Suckerman, LADC, LPCC
- Professional Counselor
- Bloomington, MN
National Provider Identifier
1114736030
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4767
- Practice address
- 1100 E 80TH St
Bloomington, MN 55420-1426 - Phone
- (952) 956-3165
- NPI assigned
- Jan 6, 2025
- Sex
- Female
- Sole proprietor
- No
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 | 4767 | MN | Primary |
Addresses
Primary practice location
1100 E 80TH St
Bloomington, MN 55420-1426
Mailing address
1100 E 80TH St
Bloomington, MN 55420-1426
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 |
|---|---|---|---|
| 4767 | MN | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736121600000",
"number": "1114736030",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 E 80TH ST",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554201426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 E 80TH ST",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554201426",
"telephone_number": "952-956-3165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUCKERMAN",
"first_name": "FAITH",
"credential": "LADC, LPCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-01-06",
"last_updated": "2025-01-06",
"certification_date": "2025-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MN",
"license": "4767",
"primary": true
}
],
"identifiers": [],
"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 Jan 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.