Individual provider Active NPI

Christina Lee Goerdt, MSED, LPCC

  • Professional Counselor
  • St Louis Park, MN
National Provider Identifier
1295621480
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CC05008 Issued in MN
Practice address
5851 Cedar Lake Rd S Ste 201
St Louis Park, MN 55416-1481
Phone
(612) 399-9996
NPI assigned
Jun 16, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X CC05008 MN Primary

Addresses

Primary practice location

5851 Cedar Lake Rd S Ste 201
St Louis Park, MN 55416-1481

Mailing address

226 Pecan Ave Apt 208
Duluth, MN 55811-2750
Phone (218) 213-8128

Other practice location 1

330 3rd St S
Virginia, MN 55792-2632
Phone (218) 741-5191

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
I20250806003399 MN Practitioner - Mental Health Counselor 0648788927 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CC05008MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA Professional CurrentSince Aug 1, 2025 Accepting new patients
Life and Light LLC Professional CurrentSince Jul 22, 2025 Accepting new patients
The Roses LLC CurrentSince Jul 1, 2025 Accepting new patients

Locations

729 Washington Ave N
Ste 600
Minneapolis, MN 55401
Phone (334) 463-3099

5851 Cedar Lake Rd S
Ste 201
St Louis Park, MN 55416
Phone (612) 399-9996

330 3rd St S
Virginia, MN 55792
Phone (218) 639-5510

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": "1750032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1295621480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 PECAN AVE APT 208",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558112750",
            "telephone_number": "218-213-8128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5851 CEDAR LAKE RD S STE 201",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161481",
            "telephone_number": "612-399-9996"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 3rd St S",
            "address_purpose": "LOCATION",
            "city": "Virginia",
            "state": "MN",
            "postal_code": "557922632",
            "country_code": "US",
            "telephone_number": "218-741-5191",
            "fax_number": "218-741-5369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOERDT",
        "first_name": "CHRISTINA",
        "middle_name": "LEE",
        "credential": "MSED, LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-16",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC05008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.