Individual provider Active NPI

Tessa M Horstmann, MA, LPCC

  • Mental Health Counselor
  • Eagan, MN
National Provider Identifier
1407453004
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2621 Issued in MN
Practice address
860 Blue Gentian Rd Ste 200
Eagan, MN 55121-1567
Phone
(612) 208-3807
NPI assigned
Oct 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2621 MN Primary

Addresses

Primary practice location

860 Blue Gentian Rd Ste 200
Eagan, MN 55121-1567

Mailing address

PO Box 1173
Lakeville, MN 55044-1173

Other practice location 1

14551 Judicial Rd
Burnsville, MN 55306-4841
Phone (952) 898-5020

Other identifiers 1

IdentifierTypeStateIssuer
261OtherMNBOARD OF BEHAVIORAL HEALTH AND THERAPY

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2621MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Vista North Counseling Mental Health CurrentSince Aug 7, 2022 Accepting new patients

Locations

860 Blue Gentian Rd
Ste 200
Saint Paul, MN 55121
Phone (612) 261-7454

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": "1601942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1407453004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1173",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550441173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 BLUE GENTIAN RD STE 200",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211567",
            "telephone_number": "612-208-3807"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14551 Judicial Rd",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "MN",
            "postal_code": "553064841",
            "country_code": "US",
            "telephone_number": "952-898-5020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HORSTMANN",
        "first_name": "TESSA",
        "middle_name": "M",
        "credential": "MA, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-06",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "2621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF BEHAVIORAL HEALTH AND THERAPY",
            "identifier": "261",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.