Active NPI
Eric Michael Mortensen, LP
- Counseling Psychologist
- Minneapolis, MN
National Provider Identifier
1184490732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- LP7005
- Practice address
- 3012 W 44TH St
Minneapolis, MN 55410-1553 - Phone
- (612) 618-0922
- NPI assigned
- Nov 27, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | LP7005 | MN | Primary |
Addresses
Primary practice location
3012 W 44TH St
Minneapolis, MN 55410-1553
Mailing address
3012 W 44TH St
Minneapolis, MN 55410-1553
Phone (612) 618-0922
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1184490732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3012 W 44TH ST",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554101553",
"telephone_number": "612-618-0922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3012 W 44TH ST",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554101553",
"telephone_number": "612-618-0922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORTENSEN",
"first_name": "ERIC",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "LP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-11-27",
"last_updated": "2023-11-27",
"certification_date": "2023-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MN",
"license": "LP7005",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.