Individual provider Active NPI

Madeleine Coulter, MA

  • Mental Health Counselor
  • Minneapolis, MN
National Provider Identifier
1639767692
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2711 Issued in MN
Practice address
2724 University Ave SE Unit B
Minneapolis, MN 55414-3210
Phone
(612) 299-1090
NPI assigned
Jan 5, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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 2711 MN Primary

Addresses

Primary practice location

2724 University Ave SE Unit B
Minneapolis, MN 55414-3210

Mailing address

3029 France Ave S Apt 307
Minneapolis, MN 55416-4259
Phone (612) 300-5518

Other practice location 1

3029 France Ave S Apt 307
Minneapolis, MN 55416-4259
Phone (612) 300-5518

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
I20240119003125 MN Practitioner - Mental Health Counselor 2769834233 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Affinity Psychological Services PCGroup PAC ID 0749528552, 66 clinicians

Practice addresses (Care Compare)

6636 Cedar Ave S
Suite 360
Richfield, MN 55423-2712
Phone (612) 268-5858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2711MNMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Psychological Services, P.C. Mental Health CurrentSince Jul 19, 2024 Accepting new patients

Locations

7401 Metro Blvd
Ste 525
Minneapolis, MN 55439

6636 Cedar Ave S
Ste 360
Richfield, MN 55423
Phone (612) 998-8934

3400 1st St N
Ste 101
Saint Cloud, MN 56303
Phone (320) 202-2000

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": "1609804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1639767692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3029 FRANCE AVE S APT 307",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164259",
            "telephone_number": "612-300-5518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2724 UNIVERSITY AVE SE UNIT B",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554143210",
            "telephone_number": "612-299-1090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3029 France Ave S Apt 307",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554164259",
            "country_code": "US",
            "telephone_number": "612-300-5518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COULTER",
        "first_name": "MADELEINE",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-05",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "2711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.