Keith Michael Terhaar

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC00833 Issued in MN

Practice address

6776 Lake Dr
210
Lino Lakes, MN 55014-1191

Phone

(763) 245-7786

NPI assigned

Nov 16, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289865600000",
    "number": "1598066995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 141ST LN NE",
            "city": "HAM LAKE",
            "state": "MN",
            "postal_code": "553046841",
            "telephone_number": "763-245-7786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6776 LAKE DR",
            "address_2": "210",
            "city": "LINO LAKES",
            "state": "MN",
            "postal_code": "550141191",
            "telephone_number": "763-245-7786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERHAAR",
        "first_name": "KEITH",
        "middle_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-16",
        "last_updated": "2010-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "LPC00833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Lino Lakes, MN
• Providers in Lino Lakes, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; 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.