Individual provider Active NPI

Greta Smylie, MA

  • Mental Health Counselor
  • Eagan, MN
National Provider Identifier
1669873378
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
4660 Slater Rd
Suite 210
Eagan, MN 55122-4047
Phone
(651) 882-6299
NPI assigned
Sep 12, 2014
Last updated
Mar 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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 NU Primary

Addresses

Primary practice location

4660 Slater Rd
Suite 210
Eagan, MN 55122-4047

Mailing address

15568 Danbury Ave W
Rosemount, MN 55068-4659
Phone (218) 341-9208

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
I20240807003409 MN Practitioner - Mental Health Counselor 0042757064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4141 Old Sibley Memorial Hwy
Eagan, MN 55122-1996
Phone (218) 341-9208

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Juniper Counseling Services LLC Mental Health CurrentSince May 27, 2024 Accepting new patients
Aurora Psychological Services LLC PastSince Jul 10, 2013 Accepting new patients

Locations

4141 Old Sibley Memorial Hwy
#H
Eagan, MN 55122
Phone (612) 578-7916

4141 Old Sibley Memorial Hwy
Saint Paul, MN 55122
Phone (612) 578-7916

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1410480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1669873378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15568 DANBURY AVE W",
            "city": "ROSEMOUNT",
            "state": "MN",
            "postal_code": "550684659",
            "telephone_number": "218-341-9208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 SLATER RD",
            "address_2": "SUITE 210",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551224047",
            "telephone_number": "651-882-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMYLIE",
        "first_name": "GRETA",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-12",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.