NPIMap

Organization Active NPI

Northeast Art Therapy LLC

  • Mental Health Counselor
  • Minneapolis, MN
National Provider Identifier
1639631708
Registry record updated Apr 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
NORTHEAST ART THERAPY LLC
Practice address
79 13TH Ave NE Ste 103a
Minneapolis, MN 55413-1073
Phone
(612) 509-9987
Fax
(612) 421-0036
NPI assigned
Apr 5, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2019

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

Authorized official

Name
Auden O'Connell, LPCCNPI 1982193140
Title
Owner
Phone
(512) 509-9987

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

79 13TH Ave NE Ste 103a
Minneapolis, MN 55413-1073

Mailing address

79 13TH Ave NE Ste 103a
Minneapolis, MN 55413-1073
Phone (612) 509-9987

National Provider Directory

National Provider Directory

Locations

79 13th Ave NE
Ste 103A
Minneapolis, MN 55413
Phone (612) 509-9987

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1554422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554422400000",
    "number": "1639631708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 13TH AVE NE STE 103A",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131073",
            "telephone_number": "612-509-9987",
            "fax_number": "612-421-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 13TH AVE NE STE 103A",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131073",
            "telephone_number": "612-509-9987",
            "fax_number": "612-421-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST ART THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-05",
        "last_updated": "2019-04-05",
        "status": "A",
        "authorized_official_last_name": "O'CONNELL",
        "authorized_official_first_name": "AUDEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-509-9987",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; 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.