Individual provider Active NPI

Marcia Michele Seebachan, LCSW

  • Mental Health Counselor
  • Edina, MN
National Provider Identifier
1508472374
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
7401 Metro Blvd Ste 250
Edina, MN 55439-3062
Phone
(612) 268-5858
NPI assigned
Sep 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 54831 TX
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

7401 Metro Blvd Ste 250
Edina, MN 55439-3062

Mailing address

7401 Metro Blvd Ste 250
Edina, MN 55439-3062
Phone (612) 268-5858

Other practice location 1

1550 American Blvd E Ste 550
Bloomington, MN 55425-3100
Phone (612) 268-5858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240122001270 MN Practitioner - Clinical Social Worker 9234559907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Group practices
Affinity Psychological Services PCGroup PAC ID 0749528552, 66 clinicians

Practice addresses (Care Compare)

1550 American Blvd E
Suite 550
Bloomington, MN 55425-1139
Phone (612) 268-5858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
54831TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Psychological Services, P.C. Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

1550 American Blvd E
Ste 550
Bloomington, MN 55425
Phone (612) 504-2031

7401 Metro Blvd
Ste 250
Minneapolis, MN 55439
Phone (612) 778-8393

7401 Metro Blvd
Ste 525
Minneapolis, MN 55439

3400 1st St N
Ste 101
Saint Cloud, MN 56303
Phone (320) 202-2000

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": "1600300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1508472374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7401 METRO BLVD STE 250",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554393062",
            "telephone_number": "612-268-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7401 METRO BLVD STE 250",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554393062",
            "telephone_number": "612-268-5858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1550 American Blvd E Ste 550",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "MN",
            "postal_code": "554253100",
            "country_code": "US",
            "telephone_number": "612-268-5858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEEBACHAN",
        "first_name": "MARCIA",
        "middle_name": "MICHELE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-17",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "54831",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.