Ophelia Vanessa Addo, LPCC
Individual provider Active NPI Mental Health Counselor · St Louis Park, MN
NPI 1609486349 · NPPES record last updated Nov 7, 2025
Key facts
- NPI
- 1609486349
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 5255 (MN)
- Practice address
- 5354 Parkdale Dr
St Louis Park, MN 55416-1603 - Phone
- (888) 364-5977
- NPI assigned
- Aug 7, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Encompass Integrative Health LLC
Practice addresses (Care Compare)
19230 Evans St NW
Suite 109
Elk River, MN 55330-1079
Phone (952) 232-6350
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251230001706 | MN | Practitioner - Mental Health Counselor | 6901392968 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5255 | MN | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bolcer Podiatry, Inc. | Current |
Accepting new patients | |
| Encompass Integrative Health, LLC | Current |
Accepting new patients | |
| Emily Program PC | Past |
Accepting new patients |
Locations
19230 Evans St NW
Ste 109
Elk River, MN 55330
Phone (763) 441-6220
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 5255 | MN | Yes |
Addresses
Primary practice location
5354 Parkdale Dr
St Louis Park, MN 55416-1603
Mailing address
1714 Bunker Lake Blvd NW Ste 108
Andover, MN 55304-4091
Phone (763) 415-7386
Other providers in St Louis Park, MN
- George Adam
- Nawal Abdulahi Adamali
- Rachel Rene Adams
- Roderick Adams
- Amina Adan
- Babatunde A Adekola
- Ifrah Badal Aden
- Saadio Hassan Aden
- Melissa Ann Adler
- Omar Adow
All providers in St Louis Park, MN · Mental Health Counselor in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 7, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.