Organization Active NPI

Traverse Counseling & Consulting

  • Mental Health Counselor
  • Minnetonka, MN
National Provider Identifier
1629449939
Registry record updated Oct 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LP1844 Issued in MN
Legal business name
TRAVERSE COUNSELING & CONSULTING
Practice address
11812 Wayzata Blvd
Minnetonka, MN 55305
Phone
(952) 595-5967
Fax
(952) 322-7037
NPI assigned
Oct 13, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2015

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

Authorized official

Name
Mr. Michael Borowiak, MSW, LICSW
Title
Owner
Phone
(952) 595-5967

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X LP1844 MN Primary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 13627 MN
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X LMFT2560 MN

Addresses

Primary practice location

11812 Wayzata Blvd
Minnetonka, MN 55305

Mailing address

11812 Wayzata Blvd, Suite 100
Minnetonka, MN 55305
Phone (952) 595-5967

National Provider Directory

National Provider Directory

Locations

11812 Wayzata Blvd
Ste 100
Minnetonka, MN 55305
Phone (651) 642-1709

NPI Registry JSON

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

{
    "created_epoch": "1444694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444694400000",
    "number": "1629449939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11812 WAYZATA BLVD, SUITE 100",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "55305",
            "telephone_number": "952-595-5967",
            "fax_number": "952-322-7037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11812 WAYZATA BLVD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "55305",
            "telephone_number": "952-595-5967",
            "fax_number": "952-322-7037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAVERSE COUNSELING & CONSULTING",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-13",
        "last_updated": "2015-10-13",
        "status": "A",
        "authorized_official_last_name": "BOROWIAK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-595-5967",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW, LICSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "LP1844",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "13627",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "LMFT2560",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.