Prakriti Chaulagain, MSN , PMHNP-BC
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Minneapolis, MN
NPI 1336723378 · NPPES record last updated May 6, 2021
Key facts
- NPI
- 1336723378
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 8167 (MN)
- Practice address
- 4027 County Road 25
Minneapolis, MN 55416-2629 - Phone
- (612) 925-6033
- Fax
- (612) 925-8496
- NPI assigned
- May 6, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Family Innovations Inc
Practice addresses (Care Compare)
9325 Upland LN N
Suite 210
Maple Grove, MN 55369-4200
Phone (612) 453-4966
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210609002475 | MN | Practitioner - Nurse Practitioner | 1759781958 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2335508 | MN | MD | Registered Nurse |
| 8167 | MN | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Innovations, Inc. | Psychiatric/Mental Health | Current |
Accepting new patients |
| West Central Counseling LLC | Past |
Accepting new patients |
Locations
121 5th Ave W
Alexandria, MN 56308
Phone (320) 759-3096
1833 3rd Ave
Anoka, MN 55303
Phone (763) 421-5535
9325 Upland Ln N
Ste 210
Maple Grove, MN 55369
Phone (612) 453-4966
Interoperability endpoints
- lifestancehealth.prakritichaulagain@149810.advancedmd-direct.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 2335508 | MN | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 8167 | MN | Yes |
Addresses
Primary practice location
4027 County Road 25
Minneapolis, MN 55416-2629
Mailing address
4240 Park Glen Rd
St Louis Park, MN 55416-5427
Phone (612) 925-6033
Other practice location 1
6200 Shingle Creek Pkwy Ste 350
Brooklyn Center, MN 55430-2155
Phone (763) 503-8560
Other providers in Minneapolis, MN
- Hai Thanh Chau
- Vivian Chau
- Muhammad Reza Chaudhry
- Monica Mitra Chaudhuri
- Aditya Chauhan
- John Anthony Chauss
- Myrna Chavarria
- Joscelyn Chavez-Alonso
- Alejandra Chavez
- Ivan J Chavez
All providers in Minneapolis, MN · Psychiatric/Mental Health Nurse Practitioner in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2021. 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.