NPIMap

Organization Active NPI

MJ Moller Consulting & Counseling, LLC

Doing business as Intrinsicum Potentia Counseling

  • Mental Health Counselor
  • Saint Paul, MN
National Provider Identifier
1508115023
Registry record updated Aug 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
01195 Issued in MN
Legal business name
MJ MOLLER CONSULTING & COUNSELING, LLC
Doing business as
Intrinsicum Potentia Counseling
Practice address
366 Selby Ave Ste 200
Saint Paul, MN 55102-2886
Phone
(612) 280-0475
Fax
(651) 224-4354
NPI assigned
Aug 29, 2012
Last updated
Aug 29, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2012

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

Authorized official

Name
Mr. Mark Judson Moller, LPCNPI 1205182201
Title
Owner/Therapist
Phone
(612) 280-0475

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 01195 MN Primary

Addresses

Primary practice location

366 Selby Ave Ste 200
Saint Paul, MN 55102-2886

Mailing address

366 Selby Ave Ste 200
Saint Paul, MN 55102-2886
Phone (612) 280-0475

Other names 1

  • Intrinsicum Potentia Counseling Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346198400000",
    "number": "1508115023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "366 SELBY AVE STE 200",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022886",
            "telephone_number": "612-280-0475",
            "fax_number": "651-224-4354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 SELBY AVE STE 200",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022886",
            "telephone_number": "612-280-0475",
            "fax_number": "651-224-4354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MJ MOLLER CONSULTING & COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-29",
        "last_updated": "2012-08-29",
        "status": "A",
        "authorized_official_last_name": "MOLLER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "JUDSON",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "612-280-0475",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "01195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intrinsicum Potentia Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; 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.