Taylor Waldvogel, MA, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC04281 Issued in MN

Practice address

2040 Woodwinds Dr
Woodbury, MN 55125-2522

Phone

(651) 259-9750

NPI assigned

Oct 11, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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 and National Provider Directory roles.

• Aris Clinic PA

  • Psychiatry Physician
  • Woodbury, MN
  • NPI 1609978063
  Medicare reassignment NPD
• Mandy Wannarka, Licsw Inc

  • Clinical Social Worker
  • Coon Rapids, MN
  • NPI 1861038515
  Medicare reassignment
• Aris Behavioral Health LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Woodbury, MN
  • NPI 1083385231
  NPD

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

{
    "created_epoch": "1696982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1609657162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 WOODWINDS DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252522",
            "telephone_number": "651-259-9750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 WOODWINDS DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252522",
            "telephone_number": "651-259-9750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDVOGEL",
        "first_name": "TAYLOR",
        "credential": "MA, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-11",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "305861",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC04281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joy Natalie Wangari Wahogo
• Sainabu Wako
• Wal-Mart Stores, Inc.
• Reidun Wald, CNP
• Elizabeth Cathryn Waldera, PHARM D
• Linda Walford, CRNA
• Walgreen Co
• Walgreen Co
• Ashley Waller
• Maya Waller

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.