Individual provider Active NPI

Ira Eden Shai, M.A. M.S.

  • Mental Health Counselor
  • Minnetonka, MN
National Provider Identifier
1255837076
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
13911 Ridgedale Dr Ste 335
Minnetonka, MN 55305-1775
Phone
(651) 231-2665
NPI assigned
Apr 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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 Primary

Addresses

Primary practice location

13911 Ridgedale Dr Ste 335
Minnetonka, MN 55305-1775

Mailing address

9800 Shelard Pkwy Ste 115
Plymouth, MN 55441-6527
Phone (651) 231-2665

Other names 1

  • Iryna Zierdt Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts, Master of Science

State licenses

LicenseStateTypeSpecialty
2515MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Segal Psychotherapy, LLC CurrentSince Nov 3, 2019 Accepting new patients

Locations

13911 Ridgedale Dr
Ste 335
Minnetonka, MN 55305
Phone (612) 361-3445

9800 Shelard Pkwy
Ste 115
Plymouth, MN 55441
Phone (763) 200-8900

Organizations & group practices 1

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": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1255837076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9800 SHELARD PKWY STE 115",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554416527",
            "telephone_number": "651-231-2665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13911 RIDGEDALE DR STE 335",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051775",
            "telephone_number": "651-231-2665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAI",
        "first_name": "IRA",
        "middle_name": "EDEN",
        "credential": "M.A. M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-02",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IRYNA",
            "last_name": "ZIERDT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minnetonka, MN

Sources for this page

Verify at the official NPI Registry.