Active NPI
Carmelita Regina Privatt, LPCC
- Professional Counselor
- Willmar, MN
National Provider Identifier
1124376611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1148
- Practice address
- 1125 6TH St SE
Willmar, MN 56201-4675 - Phone
- (320) 235-4613
- Fax
- (855) 625-7406
- NPI assigned
- Aug 15, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 907-7-15-17 | ND | |
| Professional Counselor | 101YP2500X | 1148 | MN | Primary |
Addresses
Primary practice location
1125 6TH St SE
Willmar, MN 56201-4675
Mailing address
1125 6TH St SE
Willmar, MN 56201-4675
Phone (320) 235-4613
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569456000000",
"number": "1124376611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1125 6TH ST SE",
"city": "WILLMAR",
"state": "MN",
"postal_code": "562014675",
"telephone_number": "320-235-4613",
"fax_number": "855-625-7406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1125 6TH ST SE",
"city": "WILLMAR",
"state": "MN",
"postal_code": "562014675",
"telephone_number": "320-235-4613",
"fax_number": "855-625-7406"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRIVATT",
"first_name": "CARMELITA",
"middle_name": "REGINA",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-15",
"last_updated": "2019-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "ND",
"license": "907-7-15-17",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MN",
"license": "1148",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Willmar, MN
- Prairie Lakes Youth Programs
- Prairie Lakes Youth Programs Boys Group Home
- Prairie Lakes Youth Programs Girls Group Home
- Kellie Ann Prentice, FNP - BC
- Priority Mental Health, LLC
- Jenna Prusa, LICSW
- Dean Douglas Quale, D.D.S.
- Quale, Gilbertson & Martinka, LTD.
- Lola Quale, PHARMD
- Quality Quest Health Care Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.