Individual provider Active NPI

Scott Thomas Stoltenberg, LMFT

  • Marriage & Family Therapist
  • Plymouth, MN
National Provider Identifier
1386591212
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4664 Issued in MN
Practice address
18205 45TH Ave N Ste C
Plymouth, MN 55446-4594
Phone
(763) 762-6279
NPI assigned
Mar 11, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 4664 MN Primary

Addresses

Primary practice location

18205 45TH Ave N Ste C
Plymouth, MN 55446-4594

Mailing address

18205 45TH Ave N Ste C
Plymouth, MN 55446-4594
Phone (763) 762-6279

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260505001131 MN Practitioner - Mental Health Counselor 9234607672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11280 86TH Ave N
Maple Grove, MN 55369-4510

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4664MNMDNurse Practitioner

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.

NPI Registry JSON

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

{
    "created_epoch": "1773187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1386591212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18205 45TH AVE N STE C",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554464594",
            "telephone_number": "763-762-6279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18205 45TH AVE N STE C",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554464594",
            "telephone_number": "763-762-6279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLTENBERG",
        "first_name": "SCOTT",
        "middle_name": "THOMAS",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-11",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "4664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

Verify at the official NPI Registry.