Michael Proebstle, MA, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

2310 Issued in MN

Practice address

4141 Old Sibley Memorial Hwy
Eagan, MN 55122-1996

Phone

(612) 888-3858

NPI assigned

Jan 20, 2020

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 23, 2025 through Jan 23, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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.

• Abundant Peace Counseling PC

  • Mental Health Counselor
  • Eagan, MN
  • NPI 1467122804
  NPD Authorized official

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

{
    "created_epoch": "1579478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579478400000",
    "number": "1205466125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3763 DENMARK TRL W",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551231010",
            "telephone_number": "612-888-3858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 OLD SIBLEY MEMORIAL HWY",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551221996",
            "telephone_number": "612-888-3858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROEBSTLE",
        "first_name": "MICHAEL",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-20",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MN",
            "license": "2310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prime Living MN LLC
• Prime Ride Transit, LLC
• Prime Therapeutics LLC
• Priority Care Homes LLC
• Proact, Inc.
• Professional Psychological Services, LTD
• Prosper Home Care LLC
• Psych Connect Care LLC
• Beth Marie Pugh, PT
• Purusha Counseling & Consulting, LLC

• Counselor in Eagan, MN
• Providers in Eagan, MN by specialty
• Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.