Individual provider Active NPI

Amanda Barrios-Egan

  • Professional Counselor
  • Edina, MN
National Provider Identifier
1508391558
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4529 Issued in MN
Practice address
6550 York Ave S Ste 417
Edina, MN 55435-2336
Phone
(952) 426-3034
NPI assigned
Apr 27, 2017
Last updated
Oct 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 90258 TX
Professional Counselor 101YP2500X 180009449 IL
Professional Counselor 101YP2500X 4529 MN Primary

Addresses

Primary practice location

6550 York Ave S Ste 417
Edina, MN 55435-2336

Mailing address

6550 York Ave S Ste 417
Edina, MN 55435-2336
Phone (952) 426-3034

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240219002254 TX Practitioner - Mental Health Counselor 6305280256 Reassigns benefits to 1 organization
I20241106001883 MN Practitioner - Mental Health Counselor 6305280256 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2006
Medicare assignment
May accept Medicare assignment
Group practices
Mary Mullenbach PHD LP IncGroup PAC ID 5799950283, 18 clinicians

Practice addresses (Care Compare)

6550 York Ave S
Edina, MN 55435-2336
Phone (952) 426-3034

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180009449ILMDProfessional Counselor
90258TXMDProfessional Counselor
4529MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Center LLC, CurrentSince Jan 1, 2024 Accepting new patients
Family Care Center, LLC Professional CurrentSince Jan 1, 2024 Accepting new patients
Mary Mullenbach, PHD, LP, Inc CurrentSince Oct 7, 2024 Accepting new patients

Locations

2860 S Circle Dr
Ste 109
Colorado Springs, CO 80906
Phone 71954021004002

6550 York Ave S
Ste 417
Minneapolis, MN 55435
Phone (952) 426-3034

3705 Medical Pkwy
Ste 410
Austin, TX 78705
Phone (512) 320-5779

1411 Medical Pkwy
Cedar Park, TX 78613

551 S Interstate 35
Ste 200
Round Rock, TX 78664
Phone (512) 241-7314

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1508391558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6550 YORK AVE S STE 417",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352336",
            "telephone_number": "952-426-3034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 YORK AVE S STE 417",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352336",
            "telephone_number": "952-426-3034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRIOS-EGAN",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-27",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "90258",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180009449",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "4529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.