Individual provider Active NPI

Desiree Lutterman, LPCC

  • Mental Health Counselor
  • Burnsville, MN
National Provider Identifier
1508400839
Registry record updated Oct 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2246 Issued in MN
Practice address
14551 Judicial Rd Ste 100
Burnsville, MN 55306-4991
Phone
(952) 898-5020
NPI assigned
Oct 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2246 MN Primary

Addresses

Primary practice location

14551 Judicial Rd Ste 100
Burnsville, MN 55306-4991

Mailing address

113 Chaparral Dr
Apple Valley, MN 55124-9717
Phone (952) 465-8172

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2246MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bushman Psychological Services LLC Mental Health CurrentSince Nov 3, 2019 Accepting new patients

Locations

14551 Judicial Rd
Ste 100
Burnsville, MN 55306
Phone (952) 898-5020

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1508400839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 CHAPARRAL DR",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551249717",
            "telephone_number": "952-465-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14551 JUDICIAL RD STE 100",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553064991",
            "telephone_number": "952-898-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTTERMAN",
        "first_name": "DESIREE",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-30",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "2246",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 30, 2019; 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.