Chester Mulholland, LPCC
Individual provider Active NPI Mental Health Counselor · White Bear Lake, MN
NPI 1124476965 · NPPES record last updated Apr 18, 2018
Key facts
- NPI
- 1124476965
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- LPCC 1013 (MN)
- Practice address
- 3596 Linden Ave
White Bear Lake, MN 55110-4693 - Phone
- (651) 243-2484
- NPI assigned
- Jun 2, 2016
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Allina Health System
Practice addresses (Care Compare)
280 Smith Ave N
Suite 450
St Paul, MN 55102-2481
Phone (651) 241-5959
2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (866) 603-0016
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240116003280 | MN | Practitioner - Mental Health Counselor | 1557711843 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPCC 1013 | MN | MD | Mental Health Counselor |
| 1013 | MN | MD | Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allina Health System | Current |
Accepting new patients | |
| Allina Health System | Current | Accepting new patients | |
| Allina Health System | Current |
Accepting new patients | |
| Allina Health System | Current |
Accepting new patients | |
| Allina Health System | Current | Accepting new patients |
Locations
440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225
2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640
2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813
800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547
280 Smith Ave N
Ste 450
Saint Paul, MN 55102
Phone (651) 241-5959
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPCC 1013 | MN | Yes |
Addresses
Primary practice location
3596 Linden Ave
White Bear Lake, MN 55110-4693
Mailing address
800 E 28TH St
Minneapolis, MN 55407-3723
Other practice location 1
800 E 28th St
Minneapolis, MN 55407-3723
Phone (612) 863-8513
Other providers in White Bear Lake, MN
- Mackenzie Monty
- Michele Moore
- Jason Moua
- Tony Kong Moua
- Twyla Dara Annapurna Marjo Mowll
- Grace Louise Murphy
- My Home Health Care, Inc.
- Patrick Girard Napoli
- Merica Regina Rene Neil
- Allison Joy Nelson
All providers in White Bear Lake, MN · Mental Health Counselor in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 18, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.