Individual provider Active NPI

Shelby Lynn Leske, MA, LPCC

  • Mental Health Counselor
  • Lake Elmo, MN
National Provider Identifier
1134824865
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3773 Issued in MN
Practice address
8550 Hudson Blvd N
Lake Elmo, MN 55042-5500
Phone
(651) 254-8580
NPI assigned
Apr 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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 3773 MN Primary

Addresses

Primary practice location

8550 Hudson Blvd N
Lake Elmo, MN 55042-5500

Mailing address

3244 23Rd Ave S
Minneapolis, MN 55407-5584
Phone (320) 469-2962

Other practice location 1

8640 Eagle Creek Cir
Savage, MN 55378-4400
Phone (507) 540-0584

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
I20240122003471 MN Practitioner - Mental Health Counselor 2062864473 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

8550 Hudson Blvd N
Lake Elmo, MN 55042-5500
Phone (651) 254-8580

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
3773MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Oct 1, 2024 Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. CurrentSince Oct 1, 2024 Accepting new patients
River Valley Behavioral Health & Wellness Center, PLLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

8550 Hudson Blvd N
Lake Elmo, MN 55042
Phone (651) 254-8580

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

8640 Eagle Creek Cir
Savage, MN 55378
Phone (952) 746-7664

Organizations & group practices 4

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": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1134824865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3244 23RD AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554075584",
            "telephone_number": "320-469-2962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8550 HUDSON BLVD N",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550425500",
            "telephone_number": "651-254-8580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8640 Eagle Creek Cir",
            "address_purpose": "LOCATION",
            "city": "Savage",
            "state": "MN",
            "postal_code": "553784400",
            "country_code": "US",
            "telephone_number": "507-540-0584",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LESKE",
        "first_name": "SHELBY",
        "middle_name": "LYNN",
        "credential": "MA, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-03",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "3773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elmo, MN

Sources for this page

Verify at the official NPI Registry.