Individual provider Active NPI

Anne Lehradt, MA, LPCC, LADC, ADCR

  • Professional Counselor
  • Shakopee, MN
National Provider Identifier
1225780471
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3080 Issued in MN
Practice address
200 4TH Ave W Lowr Level
Shakopee, MN 55379-1220
Phone
(952) 496-8407
NPI assigned
Jan 19, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 305268 MN
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 3080 MN Primary

Addresses

Primary practice location

200 4TH Ave W Lowr Level
Shakopee, MN 55379-1220

Mailing address

200 4TH Ave W Lowr Level
Shakopee, MN 55379-1220

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
I20240509002783 MN Practitioner - Mental Health Counselor 9032550975 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
305268MNMDAddiction (Substance Use Disorder) Counselor
3080MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Scott CurrentSince Feb 25, 2024 Accepting new patients
County of Scott Addiction (Substance Use Disorder) CurrentSince Feb 25, 2024 Accepting new patients
County of Scott Past Accepting new patients

Locations

200 4th Ave W
Lowr
Shakopee, MN 55379
Phone (952) 496-8407

200 4th Ave W
Shakopee, MN 55379
Phone (952) 496-8481

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": "1642550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1225780471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 4TH AVE W LOWR LEVEL",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 4TH AVE W LOWR LEVEL",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791220",
            "telephone_number": "952-496-8407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEHRADT",
        "first_name": "ANNE",
        "credential": "MA, LPCC, LADC, ADCR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-19",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "305268",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "3080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shakopee, MN

Sources for this page

Verify at the official NPI Registry.