Individual provider Active NPI

Patricia O'Bryant, LPCC, LADC

  • Mental Health Counselor
  • Minneapolis, MN
National Provider Identifier
1205342383
Registry record updated Apr 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CC02360 Issued in MN
Practice address
3217 Hennepin Ave Ste 3
Minneapolis, MN 55408-4695
Phone
(612) 812-8429
NPI assigned
Dec 27, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 303850 MN
Professional Counselor 101YP2500X 01618 MN
Mental Health Counselor 101YM0800X CC02360 MN Primary

Addresses

Primary practice location

3217 Hennepin Ave Ste 3
Minneapolis, MN 55408-4695

Mailing address

515 E Slaughter LN Apt 3213
Austin, TX 78744-0074
Phone (314) 494-3955

Other practice location 1

2915 S. Wayzata Blvd
Minneapolis, MN 55405-2145
Phone (612) 807-7846

Other practice location 2

516 S Pokegama Ave
Grand Rapids, MN 55744-3800
Phone (218) 328-3139

Other practice location 3

2729 13th Ave E
Hibbing, MN 55746-2314
Phone (218) 293-4789

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
303850MNMDAddiction (Substance Use Disorder) Counselor
CC02360MNMDMental Health Counselor
01618MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Through Therapy Collective, Inc CurrentSince Feb 10, 2021 Accepting new patients
Lakeview Behavioral Health Inc. Past Accepting new patients

Locations

3217 Hennepin Ave
Ste 3
Minneapolis, MN 55408
Phone (612) 460-7098

Organizations & group practices 2

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": "1514332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586908800000",
    "number": "1205342383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 E SLAUGHTER LN APT 3213",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787440074",
            "telephone_number": "314-494-3955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3217 HENNEPIN AVE STE 3",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554084695",
            "telephone_number": "612-812-8429"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2915 S. Wayzata Blvd",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554052145",
            "country_code": "US",
            "telephone_number": "612-807-7846",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "516 S Pokegama Ave",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MN",
            "postal_code": "557443800",
            "country_code": "US",
            "telephone_number": "218-328-3139",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2729 13th Ave E",
            "address_purpose": "LOCATION",
            "city": "Hibbing",
            "state": "MN",
            "postal_code": "557462314",
            "country_code": "US",
            "telephone_number": "218-293-4789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'BRYANT",
        "first_name": "PATRICIA",
        "credential": "LPCC, LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-27",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303850",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "01618",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC02360",
            "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 Apr 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.