Individual provider Active NPI

Mary A Del Vecchio, PSYD, CRC, LPC

  • Mental Health Counselor
  • Saint Paul, MN
National Provider Identifier
1356498901
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MN00915 Issued in MN
Practice address
750 Main St Ste 100
Saint Paul, MN 55118-3765
Phone
(651) 233-8036
Fax
(715) 684-6776
NPI assigned
Jan 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 235026 WI
Mental Health Counselor 101YM0800X 3846-125 WI
Mental Health Counselor 101YM0800X LPC00915 MN
Mental Health Counselor 101YM0800X MN00915 MN Primary

Addresses

Primary practice location

750 Main St Ste 100
Saint Paul, MN 55118-3765

Mailing address

2536 Wilshire CT
Mendota Heights, MN 55120-1706
Phone (651) 233-8036

Other identifiers 1

IdentifierTypeStateIssuer
ATN65153MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPC00915MNMDMental Health Counselor
MN00915MNMDMental Health Counselor
235026WIMDMental Health Counselor
3846-125WIMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1356498901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2536 WILSHIRE CT",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551201706",
            "telephone_number": "651-233-8036",
            "fax_number": "715-684-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 MAIN ST STE 100",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551183765",
            "telephone_number": "651-233-8036",
            "fax_number": "715-684-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEL VECCHIO",
        "first_name": "MARY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "PSYD, CRC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "235026",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "3846-125",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "LPC00915",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "MN00915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ATN65153",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.