Max Richard Stoltenberg, MC, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3699 Issued in MN

Practice address

5700 Bottineau Blvd Ste 210
Crystal, MN 55429-3184

Phone

(763) 330-2774

Fax

(763) 330-2775

NPI assigned

Aug 15, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Optum Behavioral Care of Colorado PCGroup PAC ID 0941648463, 196 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Optum Behavioral Care of Colorado, P.C.

  dba Northern Psychiatric Associates of Minnesota

  • Clinical Psychologist
  • Baxter, MN
  • NPI 1124898556
  Medicare reassignment Care Compare group NPD
• Care Clinics, LLC

  • Psychologist
  • St Louis Park, MN
  • NPI 1851716245
  NPD
• Optum Behavioral Care of Colorado, P.C.

  • Clinical Social Worker
  • De Pere, WI
  • NPI 1396622494
  NPD
• Optum Behavioral Care of Colorado PC

  dba Care Counseling of Minnesota

  • Psychologist
  • Edina, MN
  • NPI 1336967561
  NPD (past)

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

{
    "created_epoch": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708128000000",
    "number": "1184870610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121786",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 BOTTINEAU BLVD STE 210",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554293184",
            "telephone_number": "763-330-2774",
            "fax_number": "763-330-2775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLTENBERG",
        "first_name": "MAX",
        "middle_name": "RICHARD",
        "credential": "MC, LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-15",
        "last_updated": "2024-02-17",
        "certification_date": "2024-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "3699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Stalberger, CPHT
• State of MN Receivership - Terrace Crystal (The Terrace at Crystal)
• Michelle Steele
• Timothy Todd Stenzel, MD, PHD
• Henry Lincoln Stewart
• Gregory Studelska III, ED.S.
• Suite Living Senior Care of Crystal
• Supervalu Pharmacies Inc (Cub Pharmacy)
• Supreme Health Care Inc
• Shavon Swain, LICSW

• Professional Counselor in Crystal, MN
• Providers in Crystal, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.