Active NPI
Ashley Miller
- Professional Counselor
- Fridley, MN
National Provider Identifier
1619413382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2737
- Practice address
- 1250 Moore Lake Dr E Ste 152
Fridley, MN 55432-5135 - Phone
- (612) 389-2332
- Fax
- (612) 389-2338
- NPI assigned
- Jan 18, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2737 | MN | Primary |
| Professional Counselor | 101YP2500X | 3404 | WI | |
| Mental Health Counselor | 101YM0800X | 02330 | MN |
Addresses
Primary practice location
1250 Moore Lake Dr E Ste 152
Fridley, MN 55432-5135
Mailing address
1250 Moore Lake Dr E Ste 152
Fridley, MN 55432-5135
Phone (612) 389-2332
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02330 | MN | MD | Mental Health Counselor |
| 2737 | MN | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mindful Way Counseling, LLC | Professional | Past | Accepting new patients |
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": "1484697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612224000000",
"number": "1619413382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1250 MOORE LAKE DR E STE 152",
"city": "FRIDLEY",
"state": "MN",
"postal_code": "554325135",
"telephone_number": "612-389-2332",
"fax_number": "612-389-2338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 MOORE LAKE DR E STE 152",
"city": "FRIDLEY",
"state": "MN",
"postal_code": "554325135",
"telephone_number": "612-389-2332",
"fax_number": "612-389-2338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "ASHLEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-18",
"last_updated": "2021-02-02",
"certification_date": "2021-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MN",
"license": "2737",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "3404",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MN",
"license": "02330",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fridley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.