Active NPI
Mara Jane Fusco, LPCC
- Professional Counselor
- Burnsville, MN
National Provider Identifier
1568949774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- CC01867
- Practice address
- 12400 Portland Ave Ste 180
Burnsville, MN 55337-6875 - Phone
- (651) 689-3012
- Fax
- (651) 352-6070
- NPI assigned
- Jul 20, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | CC01867 | MN | Primary |
Addresses
Primary practice location
12400 Portland Ave Ste 180
Burnsville, MN 55337-6875
Mailing address
3450 Oleary LN
Eagan, MN 55123-2340
Phone (651) 454-0114
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3450 Oleary LN
Eagan, MN 55123-2340
Phone (651) 454-0114
5346 Lyndale Ave S
Minneapolis, MN 55419-1230
Phone (612) 746-5888
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 2
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.
-
- Clinical Psychologist
- Eagan, MN
- NPI 1144311184
-
- Mental Health Counselor
- Bloomington, MN
- NPI 1649163874
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770076800000",
"number": "1568949774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3450 OLEARY LN",
"city": "EAGAN",
"state": "MN",
"postal_code": "551232340",
"telephone_number": "651-454-0114",
"fax_number": "651-454-3492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12400 PORTLAND AVE STE 180",
"city": "BURNSVILLE",
"state": "MN",
"postal_code": "553376875",
"telephone_number": "651-689-3012",
"fax_number": "651-352-6070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUSCO",
"first_name": "MARA",
"middle_name": "JANE",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-20",
"last_updated": "2026-02-03",
"certification_date": "2026-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MN",
"license": "CC01867",
"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 Feb 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.