Individual provider Active NPI

Amy Perry, MA

  • Professional Counselor
  • Saint Paul, MN
National Provider Identifier
1144005596
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CC04317 Issued in MN
Practice address
1595 Selby Ave
Saint Paul, MN 55104-6221
Phone
(612) 226-8993
NPI assigned
Aug 25, 2023
Last updated
Oct 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X CC04317 MN Primary

Addresses

Primary practice location

1595 Selby Ave
Saint Paul, MN 55104-6221

Mailing address

2098 Upper Saint Dennis Rd
Saint Paul, MN 55116-2847
Phone (612) 226-8993

Other names 1

  • Amy Hayden Former name

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
I20241122001251 MN Practitioner - Mental Health Counselor 4183159536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1155 Northland Dr
Mendota Heights, MN 55120-1288
Phone (612) 223-8898

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CC04317MNMDProfessional Counselor
4317MNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Colorado, P.C. Single Specialty Current Accepting new patients
Optum Behavioral Care of Colorado PC CurrentSince Sep 19, 2024 Accepting new patients
Optum Behavioral Care of Colorado, P.C. CurrentSince Sep 19, 2024 Accepting new patients
Care Clinics, LLC Single Specialty CurrentSince Dec 23, 2024 Accepting new patients

Locations

7400 W 109th St
Bloomington, MN 55438
Phone (952) 886-3268

11000 Optum Cir
Eden Prairie, MN 55344

1155 Northland Dr
Saint Paul, MN 55120
Phone (612) 223-8899

7601 Wayzata Blvd
St Louis Park, MN 55426
Phone (612) 223-8899

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, 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": "1692921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1144005596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2098 UPPER SAINT DENNIS RD",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551162847",
            "telephone_number": "612-226-8993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1595 SELBY AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046221",
            "telephone_number": "612-226-8993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "AMY",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-25",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC04317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "HAYDEN",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.