Active NPI
Christopher Ronald Thole
- Mental Health Counselor
- Maplewood, MN
National Provider Identifier
1619251022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 2115 County Road D E
Suite B
Maplewood, MN 55109-5353 - Phone
- (651) 748-5019
- Fax
- (651) 773-7591
- NPI assigned
- Oct 4, 2011
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
2115 County Road D E
Suite B
Maplewood, MN 55109-5353
Mailing address
2115 County Road D E
Suite B
Maplewood, MN 55109-5353
Phone (651) 748-5019
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
- Marriage and Family Therapist
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
7580 160TH St W
Lakeville, MN 55044-8348
Phone (952) 898-1133
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Life Development Resources, PA | Mental Health | Current | Accepting new patients |
Locations
7580 160th St W
Lakeville, MN 55044
Phone (952) 898-1133
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Lakeville, MN
- NPI 1902953169
Mental Health
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317686400000",
"number": "1619251022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2115 COUNTY ROAD D E",
"address_2": "SUITE B",
"city": "MAPLEWOOD",
"state": "MN",
"postal_code": "551095353",
"telephone_number": "651-748-5019",
"fax_number": "651-773-7591"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2115 COUNTY ROAD D E",
"address_2": "SUITE B",
"city": "MAPLEWOOD",
"state": "MN",
"postal_code": "551095353",
"telephone_number": "651-748-5019",
"fax_number": "651-773-7591"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOLE",
"first_name": "CHRISTOPHER",
"middle_name": "RONALD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-04",
"last_updated": "2011-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Maplewood, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.