Active NPI
Glenn Ragsdale Nuckols, LADC, LPCC
- Professional Counselor
- Minneapolis, MN
National Provider Identifier
1477489698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 5648
- Practice address
- 4749 Chicago Ave Ste 2B
Minneapolis, MN 55407-4181 - Phone
- (612) 361-7885
- NPI assigned
- Jun 23, 2026
- Sex
- Unspecified or another gender identity
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 306818 | MN | |
| Professional Counselor | 101YP2500X | 5648 | MN | Primary |
Addresses
Primary practice location
4749 Chicago Ave Ste 2B
Minneapolis, MN 55407-4181
Mailing address
4749 Chicago Ave Ste 2B
Minneapolis, MN 55407-4181
Phone (612) 361-7885
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
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": "1782172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782172800000",
"number": "1477489698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4749 CHICAGO AVE STE 2B",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554074181",
"telephone_number": "612-361-7885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4749 CHICAGO AVE STE 2B",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554074181",
"telephone_number": "612-361-7885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NUCKOLS",
"first_name": "GLENN",
"middle_name": "RAGSDALE",
"credential": "LADC, LPCC",
"sole_proprietor": "YES",
"sex": "X",
"enumeration_date": "2026-06-23",
"last_updated": "2026-06-23",
"certification_date": "2026-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MN",
"license": "306818",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MN",
"license": "5648",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.