NPIMap

Organization Active NPI

Professional Counseling Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Minnetonka, MN
National Provider Identifier
1477821791
Registry record updated Dec 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
PROFESSIONAL COUNSELING CENTER
Practice address
12450 Wayzata Blvd Ste 202
Minnetonka, MN 55305-1927
Phone
(952) 548-9340
Fax
(952) 548-9350
NPI assigned
Dec 1, 2011
Organization subpart
Yes
Parent organization
NORTHERN INTEGRATED HEALTH INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 1, 2011

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

Authorized official

Name
Mrs. Sarah Grill
Title
Office Manager
Phone
(952) 548-9340

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

12450 Wayzata Blvd Ste 202
Minnetonka, MN 55305-1927

Mailing address

12450 Wayzata Blvd Ste 202
Minnetonka, MN 55305-1927
Phone (952) 548-9340

National Provider Directory

National Provider Directory
Tax ID family
Northern Integrated Health Inc4 organizations share this tax ID, including this one
Part of
Northern Integrated Health Inc

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12450 Wayzata Blvd
Ste 202
Minnetonka, MN 55305
Phone (952) 548-9340

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1322697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322697600000",
    "number": "1477821791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12450 WAYZATA BLVD STE 202",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051927",
            "telephone_number": "952-548-9340",
            "fax_number": "952-548-9350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12450 WAYZATA BLVD STE 202",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051927",
            "telephone_number": "952-548-9340",
            "fax_number": "952-548-9350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL COUNSELING CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHERN INTEGRATED HEALTH INC",
        "enumeration_date": "2011-12-01",
        "last_updated": "2011-12-01",
        "status": "A",
        "authorized_official_last_name": "GRILL",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "952-548-9340",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; 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.