Individual provider Active NPI

Elise Nathalie Meger

  • Mental Health Counselor
  • Minneapolis, MN
National Provider Identifier
1538775143
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
3033 Excelsior Blvd Ste 215
Minneapolis, MN 55416-5274
Phone
(612) 268-4777
NPI assigned
Sep 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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 Primary

Addresses

Primary practice location

3033 Excelsior Blvd Ste 215
Minneapolis, MN 55416-5274

Mailing address

130 Groveland Ter
Minneapolis, MN 55403-1148
Phone (612) 268-4777

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
I20240116001494 MN Practitioner - Mental Health Counselor 5597117531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Lyn-Lake Psychotherapy and Wellness LTDGroup PAC ID 9638581291, 72 clinicians

Practice addresses (Care Compare)

621 W Lake St
Suite 350
Minneapolis, MN 55408-2952
Phone (612) 979-2276

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lyn-Lake Psychotherapy and Wellness LTD. Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

3033 Excelsior Blvd
Ste 215
Minneapolis, MN 55416
Phone (612) 293-6523

621 W Lake St
Ste 350
Minneapolis, MN 55408
Phone (612) 547-9990

2900 Thomas Ave S
Ste 100
Minneapolis, MN 55416

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": "1600387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1538775143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 GROVELAND TER",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554031148",
            "telephone_number": "612-268-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 EXCELSIOR BLVD STE 215",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554165274",
            "telephone_number": "612-268-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEGER",
        "first_name": "ELISE",
        "middle_name": "NATHALIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-18",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.