Shelby Lautz, LPCC, LADC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4134 Issued in MN

Practice address

1045 Stoughton Ave
Chaska, MN 55318-2149

Phone

(952) 448-6557

Fax

(952) 448-6047

NPI assigned

Dec 8, 2023

Last updated

Dec 8, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sandsted Wellness LLC

  • Professional Counselor
  • Lakeville, MN
  • NPI 1780553925
  Medicare reassignment NPD

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

{
    "created_epoch": "1701993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1578330569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 E 2ND ST",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553181906",
            "telephone_number": "952-856-3932",
            "fax_number": "952-448-6047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 STOUGHTON AVE",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553182149",
            "telephone_number": "952-448-6557",
            "fax_number": "952-448-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUTZ",
        "first_name": "SHELBY",
        "credential": "LPCC, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-08",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "306116",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "4134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connor Larson
• Lisa Carol Larson, PAC
• Melissa Goroni Larson, LICSW
• Elissabeth Amanda Lauren, LPCC
• Michelle Palen Laurent, M.S., CCC-SLP
• Melissa Tauer Lee, LICSW
• Allison Lehrke
• Rachel Lynn Leier, FNP-C
• Kimberly A Lenz, MA CCC SLP
• Jill Lenzmeier, MSW, LGSW

• Professional Counselor in Chaska, MN
• Providers in Chaska, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; 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.

Verify at the official NPI Registry.