Organization Active NPI

Heartland Counseling, LLC

  • Marriage & Family Therapist
  • Burnsville, MN
National Provider Identifier
1467999136
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1251 Issued in MN
Legal business name
HEARTLAND COUNSELING, LLC
Practice address
11990 Portland Ave
Burnsville, MN 55337-1516
Phone
(952) 736-8393
Fax
(952) 479-7896
NPI assigned
Jan 19, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Authorized official

Name
Sharon Joyce Petersen, LMFTNPI 1275593949
Title
Owner
Phone
(612) 636-1107

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X 1251 MN Primary

Addresses

Primary practice location

11990 Portland Ave
Burnsville, MN 55337-1516

Mailing address

11990 Portland Ave
Burnsville, MN 55337-1516
Phone (952) 736-8393

Other identifiers 2

IdentifierTypeStateIssuer
1275593949OtherMNINDIVIDUAL NPI NUMBER
1467999136OtherMNMARRIAGE & FAMILY THERAPIST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240517001229 MN Part B Supplier - Clinic/Group Practice 6406297795 Receives reassigned benefits from 3 practitioners
Practice locations: Burnsville, MN

National Provider Directory

National Provider Directory

Locations

190 S River Ridge Cir
Ste 209
Burnsville, MN 55337

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742774400000",
    "number": "1467999136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11990 PORTLAND AVE",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553371516",
            "telephone_number": "952-736-8393",
            "fax_number": "952-479-7896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11990 PORTLAND AVE",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553371516",
            "telephone_number": "952-736-8393",
            "fax_number": "952-479-7896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-19",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "JOYCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-636-1107",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1275593949",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARRIAGE & FAMILY THERAPIST",
            "identifier": "1467999136",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.