Individual provider Active NPI

Christopher Ronald Thole

  • Mental Health Counselor
  • Maplewood, MN
National Provider Identifier
1619251022
Registry record updated Oct 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
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

Updated by the provider on Oct 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240228000672 MN Practitioner - Marriage and Family Therapist 4183069313 Reassigns benefits to 1 organization

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
Life Development Resources PAGroup PAC ID 5890779847, 20 clinicians

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

OrganizationSpecialtyStatusNew patients
Life Development Resources, PA Mental Health CurrentSince Jan 1, 2024 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.

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

Verify at the official NPI Registry.