Active NPI
Denise Lynn Wing, M.A., LMFT
- Mental Health Counselor
- Edina, MN
National Provider Identifier
1336208503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 1812
- Practice address
- 7401 Metro Blvd Ste 250
Edina, MN 55439-3062 - Phone
- (612) 268-5858
- Fax
- (612) 268-5868
- NPI assigned
- Dec 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 1812 | MN | |
| Mental Health Counselor | 101YM0800X | 1812 | MN | Primary |
Addresses
Primary practice location
7401 Metro Blvd Ste 250
Edina, MN 55439-3062
Mailing address
9400 Zane Ave N
Brooklyn Park, MN 55443-1814
Phone (763) 762-8800
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336208503 | Medicaid | MN | |
| 1336208503 | Other | MN | BLUE CROSS BLUE SHIELD |
| 1336208503 | Other | MN | HEALTH PARTNERS |
| 2191290 | Other | MN | COMPSYCH EAP |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1812 | MN | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Affinity Psychological Services, P.C. | Mental Health | Current | Accepting new patients |
Locations
7401 Metro Blvd
Ste 525
Minneapolis, MN 55439
7401 Metro Blvd
Ste 250
Minneapolis, MN 55439
Phone (612) 778-8393
3400 1st St N
Ste 101
Saint Cloud, MN 56303
Phone (320) 202-2000
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Counselor
- Edina, MN
- NPI 1245610856
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728345600000",
"number": "1336208503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9400 ZANE AVE N",
"city": "BROOKLYN PARK",
"state": "MN",
"postal_code": "554431814",
"telephone_number": "763-762-8800",
"fax_number": "763-315-4669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7401 METRO BLVD STE 250",
"city": "EDINA",
"state": "MN",
"postal_code": "554393062",
"telephone_number": "612-268-5858",
"fax_number": "612-268-5868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WING",
"first_name": "DENISE",
"middle_name": "LYNN",
"credential": "M.A., LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-06",
"last_updated": "2024-10-08",
"certification_date": "2024-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "1812",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MN",
"license": "1812",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1336208503",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "1336208503",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "1336208503",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMPSYCH EAP",
"identifier": "2191290",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Edina, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.