Individual provider Active NPI

Shelli N Halbersma, LPCC

  • Professional Counselor
  • Saint Paul, MN
National Provider Identifier
1174941223
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1526 Issued in MN
Practice address
2265 Como Ave
Saint Paul, MN 55108
Phone
(651) 645-5323
Fax
(844) 358-8786
NPI assigned
Apr 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 01445 MN
Professional Counselor 101YP2500X 1526 MN Primary

Addresses

Primary practice location

2265 Como Ave
Saint Paul, MN 55108

Mailing address

2265 Como Ave
Saint Paul, MN 55108-1737
Phone (651) 645-5323

Other practice location 1

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-5000

Other practice location 2

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-5000

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
I20260206003552 MN Practitioner - Mental Health Counselor 3274012596 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

500 S Maple St
Waconia, MN 55387-1971

500 S Maple St
Attn Medical Staff Services
Waconia, MN 55837-1791

PO Box
Suite 43
Minneapolis, MN 55440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01445MNMDProfessional Counselor
1526MNMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Francis Regional Medical Center CurrentSince Mar 9, 2026 Accepting new patients
St Francis Regional Medical Center CurrentSince Mar 9, 2026 Accepting new patients

Locations

265 Creek Ln S
Jordan, MN 55352
Phone (952) 428-1200

1455 Saint Francis Ave
Shakopee, MN 55379
Phone (952) 403-2200

Organizations & group practices 3

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": "1396569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1174941223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2265 COMO AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081737",
            "telephone_number": "651-645-5323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2265 COMO AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55108",
            "telephone_number": "651-645-5323",
            "fax_number": "844-358-8786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2925 Chicago Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554071321",
            "country_code": "US",
            "telephone_number": "612-262-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2925 Chicago Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554071321",
            "country_code": "US",
            "telephone_number": "612-262-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALBERSMA",
        "first_name": "SHELLI",
        "middle_name": "N",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-04",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "01445",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "1526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.