NPIMap

Organization Active NPI

Amanda Vaske LLC

  • Marriage & Family Therapist
  • White Bear Lake, MN
National Provider Identifier
1346759180
Registry record updated Oct 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
AMANDA VASKE LLC
Practice address
1310 Highway 96 E
White Bear Lake, MN 55110-3624
Phone
(651) 329-1266
NPI assigned
Sep 25, 2017
Last updated
Oct 23, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2017

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

Authorized official

Name
Ms. Amanda Vaske, MA, LMFTNPI 1063696300
Title
Owner
Phone
(651) 329-1266

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Counseling Psychologist 103TC1900X
Clinical Social Worker 1041C0700X
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

1310 Highway 96 E
White Bear Lake, MN 55110-3624

Mailing address

1310 Highway 96 E Ste 211
White Bear Lake, MN 55110-3619
Phone (651) 329-1266

Other identifiers 1

IdentifierTypeStateIssuer
1063696300MedicaidMN

National Provider Directory

National Provider Directory

Locations

1310 Highway 96 E
Ste 211
White Bear Lake, MN 55110
Phone (651) 329-1266

1310 Highway 96 E
White Bear Lk, MN 55110
Phone (651) 426-3071

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1506297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508716800000",
    "number": "1346759180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 HIGHWAY 96 E STE 211",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103619",
            "telephone_number": "651-329-1266",
            "fax_number": "651-846-5312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 HIGHWAY 96 E",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103624",
            "telephone_number": "651-329-1266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMANDA VASKE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-25",
        "last_updated": "2017-10-23",
        "status": "A",
        "authorized_official_last_name": "VASKE",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-329-1266",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA, LMFT"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063696300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Bear Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.