Abigail Amundson, CLINICAL INTERN
Individual provider Active NPI Professional Counselor · Minnetonka, MN
NPI 1306322433 · NPPES record last updated Jan 15, 2020
Key facts
- NPI
- 1306322433
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- Practice address
- 13911 Ridgedale Dr Ste 460
Minnetonka, MN 55305-1777 - Phone
- (763) 445-9175
- Fax
- (888) 675-8262
- NPI assigned
- Jul 11, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2019
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Rush Inc
Practice addresses (Care Compare)
1751 Tower Dr W
Suite 200
Stillwater, MN 55082-7596
Phone (651) 439-2059
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240125004032 | MN | Practitioner - Mental Health Counselor | 2163871815 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rush Inc | Current |
Accepting new patients |
Locations
13911 Ridgedale Dr
Ste 460
Minnetonka, MN 55305
Phone (651) 439-2059
1751 Tower Dr W
Ste 200
Stillwater, MN 55082
Phone (651) 439-2059
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Yes |
Addresses
Primary practice location
13911 Ridgedale Dr Ste 460
Minnetonka, MN 55305-1777
Mailing address
13911 Ridgedale Dr Ste 460
Minnetonka, MN 55305-1777
Phone (763) 445-9175
Other practice location 1
12000 Elm Creek Blvd N Ste L70
Maple Grove, MN 55369-7167
Phone (763) 898-3838
Other providers in Minnetonka, MN
- John Peter Amdahl
- Americare Chiropractic, P.a.
- Peter S. Ames
- Jaclyn Victoria Amoateng
- Karie Amstutz
- Sara Jane Amundson
- Anchored Orthodontics PLLC
- Ashley Carol Andersen
- Mari Gwyn Anderson Fairchild
- Alex Kelly Anderson
All providers in Minnetonka, MN · Professional Counselor in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.