Marina Joanne Mitcheltree, M.A., LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC00376 Issued in MN

Practice address

3395 Plymouth Rd
St. David's Center for Child & Family Development
Minnetonka, MN 55305-3765

Phone

(952) 939-0396

Fax

(952) 548-8760

NPI assigned

Sep 5, 2013

Last updated

Jan 6, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1699100909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3395 PLYMOUTH RD",
            "address_2": "ST. DAVID'S CENTER FOR CHILD & FAMILY DEVELOPMENT",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553053765",
            "telephone_number": "952-939-0396",
            "fax_number": "952-548-8760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3395 PLYMOUTH RD",
            "address_2": "ST. DAVID'S CENTER FOR CHILD & FAMILY DEVELOPMENT",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553053765",
            "telephone_number": "952-939-0396",
            "fax_number": "952-548-8760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELTREE",
        "first_name": "MARINA",
        "middle_name": "JOANNE",
        "credential": "M.A., LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-05",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC00376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; 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.