Individual provider Active NPI

Chester Mulholland, LPCC

  • Mental Health Counselor
  • White Bear Lake, MN
National Provider Identifier
1124476965
Registry record updated Apr 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPCC 1013 Issued in MN
Practice address
3596 Linden Ave
White Bear Lake, MN 55110-4693
Phone
(651) 243-2484
NPI assigned
Jun 2, 2016
Last updated
Apr 18, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2018

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 LPCC 1013 MN Primary

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

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
I20240116003280 MN Practitioner - Mental Health Counselor 1557711843 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 87 NPIs, 3,844 clinicians

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPCC 1013MNMDMental Health Counselor
1013MNMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Jan 2, 2024 Accepting new patients
Allina Health System CurrentSince Jan 2, 2024 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Jan 2, 2024 Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

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

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1464825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524009600000",
    "number": "1124476965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E 28TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3596 LINDEN AVE",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551104693",
            "telephone_number": "651-243-2484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 E 28th St",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554073723",
            "country_code": "US",
            "telephone_number": "612-863-8513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULHOLLAND",
        "first_name": "CHESTER",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-02",
        "last_updated": "2018-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "LPCC 1013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Bear Lake, MN

Sources for this page

Verify at the official NPI Registry.