Individual provider Active NPI

Alivia Ebacher, LMFT

  • Mental Health Counselor
  • Roseville, MN
National Provider Identifier
1245901859
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3955 Issued in MN
Practice address
1611 County Road B W Ste 204
Roseville, MN 55113-4053
Phone
(651) 354-1933
NPI assigned
Sep 23, 2021
Last updated
Sep 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 3955 MN Primary

Addresses

Primary practice location

1611 County Road B W Ste 204
Roseville, MN 55113-4053

Mailing address

1611 County Road B W Ste 204
Roseville, MN 55113-4053
Phone (651) 354-1933

Other identifiers 1

IdentifierTypeStateIssuer
1770912271MedicaidMN

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
I20240103004016 MN Practitioner - Marriage and Family Therapist 0446601454 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (866) 603-0016

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3955MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Apr 6, 2024 Accepting new patients
Minnesota Valley Health Center Inc CurrentSince Sep 22, 2025 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System Current Accepting new patients
Ridgeview Medical Center Current Accepting new patients
Ridgeview Medical Center CurrentSince Sep 22, 2025 Accepting new patients
Minnesota Valley Health Center Inc CurrentSince Sep 22, 2025 Accepting new patients
Sibley Medical Center CurrentSince Sep 22, 2025 Accepting new patients
Ridgeview Medical Center CurrentSince Sep 22, 2025 Accepting new patients
Allina Health System CurrentSince Jan 1, 2024 Accepting new patients
Allina Health System CurrentSince Jan 1, 2024 Accepting new patients
Ridgeview Medical Center Past Accepting new patients
MN Couple Therapy Center PastSince Sep 28, 2021 Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

601 W Chandler St
Arlington, MN 55307
Phone (507) 964-2271

7907 Powers Blvd
Chanhassen, MN 55317
Phone (952) 934-0570

111 Hundertmark Rd
Ste 120
Chaska, MN 55318
Phone (952) 856-4001

621 S 4th St
Le Sueur, MN 56058
Phone (507) 665-3375

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

500 S Maple St
Waconia, MN 55387
Phone (612) 442-2191

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1632355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1245901859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 COUNTY ROAD B W STE 204",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551134053",
            "telephone_number": "651-354-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 COUNTY ROAD B W STE 204",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551134053",
            "telephone_number": "651-354-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBACHER",
        "first_name": "ALIVIA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-23",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "3955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770912271",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

Verify at the official NPI Registry.