Individual provider Active NPI

Michael Bahr Perry

  • Mental Health Counselor
  • North Branch, MN
National Provider Identifier
1467095992
Registry record updated Oct 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
5842 Old Main St Ste 234
North Branch, MN 55056-6687
Phone
(651) 401-3074
NPI assigned
Oct 28, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2019

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 Primary

Addresses

Primary practice location

5842 Old Main St Ste 234
North Branch, MN 55056-6687

Mailing address

2832 Aspen Lake Dr NE
Blaine, MN 55449-3100
Phone (612) 423-6200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mperry@canvashealth.org Direct

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

NPI Registry JSON

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1467095992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2832 ASPEN LAKE DR NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554493100",
            "telephone_number": "612-423-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5842 OLD MAIN ST STE 234",
            "city": "NORTH BRANCH",
            "state": "MN",
            "postal_code": "550566687",
            "telephone_number": "651-401-3074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "MICHAEL",
        "middle_name": "BAHR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-28",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mperry@canvashealth.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5842 Old Main St Ste 234",
            "city": "North Branch",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550566687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in North Branch, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; 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.