Individual provider Active NPI

Maggie Jan Mooney, LPCC, LPC, LADC

  • Professional Counselor
  • Hudson, WI
National Provider Identifier
1689383861
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
127072-125 Issued in WI
Practice address
625 Commerce Dr Ste 119
Hudson, WI 54016-8282
Phone
(612) 356-2449
NPI assigned
Nov 16, 2022
Last updated
Jun 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X 306607 MN
Professional Counselor 101YP2500X 05050 MN
Professional Counselor 101YP2500X 127072-125 WI Primary

Addresses

Primary practice location

625 Commerce Dr Ste 119
Hudson, WI 54016-8282

Mailing address

625 Commerce Dr Ste 119
Hudson, WI 54016-8282

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 Optum Cir
Eden Prairie, MN 55344-2956

7601 Wayzata Blvd
Saint Louis Park, MN 55426-1623

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
306607MNMDAddiction (Substance Use Disorder) Counselor
05050MNMDProfessional Counselor
127072-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Colorado, P.C. CurrentSince Jul 1, 2025 Accepting new patients
Optum Behavioral Care of Colorado, P.C. CurrentSince Jul 1, 2025 Accepting new patients
Pine Valley Counseling LLC CurrentSince Nov 20, 2022 Accepting new patients

Locations

7400 W 109th St
Bloomington, MN 55438
Phone (952) 886-3268

8980 Hudson Blvd N
Lake Elmo, MN 55042
Phone (651) 501-1467

1155 Northland Dr
Saint Paul, MN 55120
Phone (612) 223-8899

7601 Wayzata Blvd
St Louis Park, MN 55426
Phone (612) 223-8899

625 Commerce Dr
Ste 119
Hudson, WI 54016
Phone (612) 356-2449

Organizations & group practices 3

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": "1668556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1689383861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 COMMERCE DR STE 119",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540168282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 COMMERCE DR STE 119",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540168282",
            "telephone_number": "612-356-2449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONEY",
        "first_name": "MAGGIE",
        "middle_name": "JAN",
        "credential": "LPCC, LPC, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-16",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "306607",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "05050",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "127072-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, WI

Sources for this page

Verify at the official NPI Registry.