Active NPI
Tahmi Perzichilli
- Mental Health Counselor
- Minneapolis, MN
National Provider Identifier
1336556133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 00875
- Practice address
- 525 Portland Ave
Mc965
Minneapolis, MN 55415-1533 - Phone
- (612) 596-1223
- NPI assigned
- Jul 14, 2014
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 00875 | MN | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 304021 | MN |
Addresses
Primary practice location
525 Portland Ave
Mc965
Minneapolis, MN 55415-1533
Mailing address
525 Portland Ave
Mc965
Minneapolis, MN 55415-1533
Phone (612) 596-1223
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
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2011
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
658 Grand Ave
Suite 201
Saint Paul, MN 55105-3417
7525 Mitchell Rd
Suite 215
Eden Prairie, MN 55344-1900
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 304021 | MN | MD | Addiction (Substance Use Disorder) Counselor |
| 00875 | MN | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grander Peace Counseling LLC | Current | Accepting new patients |
Locations
658 Grand Ave
Ste 201
Saint Paul, MN 55105
Phone (612) 454-1656
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.
-
- Community/Behavioral Health Agency
- Saint Paul, MN
- NPI 1013486505
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421020800000",
"number": "1336556133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 PORTLAND AVE",
"address_2": "MC965",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554151533",
"telephone_number": "612-596-1223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 PORTLAND AVE",
"address_2": "MC965",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554151533",
"telephone_number": "612-596-1223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERZICHILLI",
"first_name": "TAHMI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-14",
"last_updated": "2015-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MN",
"license": "00875",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MN",
"license": "304021",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2015; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.