Tanya Lynne Eubanks, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC02302 Issued in MN

Practice address

9141 30TH Ave N
New Hope, MN 55427-2301

Phone

(612) 607-9794

Fax

(763) 951-2335

NPI assigned

Dec 27, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  MN

  Medicare reassignment NPD
• JBM Individual & Family Counseling LLC

  • Community/Behavioral Health Agency
  • New Hope, MN
  • NPI 1245863018
  NPD Authorized official
• Catholic Charities of the Diocese of St. Cloud

  • Adolescent and Children Mental Health Clinic/Center
  • Saint Cloud, MN
  • NPI 1124156609
  NPD (past)

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

{
    "created_epoch": "1577404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577404800000",
    "number": "1346889052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9141 30TH AVE N",
            "city": "NEW HOPE",
            "state": "MN",
            "postal_code": "554272301",
            "telephone_number": "612-607-9794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9141 30TH AVE N",
            "city": "NEW HOPE",
            "state": "MN",
            "postal_code": "554272301",
            "telephone_number": "612-607-9794",
            "fax_number": "763-951-2335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUBANKS",
        "first_name": "TANYA",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-27",
        "last_updated": "2019-12-27",
        "certification_date": "2019-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC02302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "JBMcouseling@yahoo.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9141 30th Ave N",
            "city": "New Hope",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554272301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Abdirihman Farah

• Mental Health Counselor in New Hope, MN
• Providers in New Hope, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2019; 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.

Verify at the official NPI Registry.