NPIMap

Organization Active NPI

4 Counsel, P.a.

Doing business as 4Counsel

  • Mental Health Counselor
  • Maple Grove, MN
National Provider Identifier
1699202952
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CC01429 Issued in MN
Legal business name
4 COUNSEL, P.A.
Doing business as
4Counsel
Practice address
11292 86TH Ave N Ste 106
Maple Grove, MN 55369-4510
Phone
(952) 300-5908
NPI assigned
May 17, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Kristine Doten, MA, LPCCNPI 1700284452
Title
Owner
Phone
(952) 300-5908

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 Counselor 101YM0800X CC01429 MN Primary

Addresses

Primary practice location

11292 86TH Ave N Ste 106
Maple Grove, MN 55369-4510

Mailing address

11292 86TH Ave N Ste 106
Maple Grove, MN 55369-4510
Phone (952) 300-5908

Other names 1

  • 4COUNSEL Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240916002453 MN Part B Supplier - Clinic/Group Practice 3971044124 Receives reassigned benefits from 3 practitioners
Practice locations: Maple Grove, MN

National Provider Directory

National Provider Directory

Locations

11292 86th Ave N
Ste 104
Maple Grove, MN 55369

11292 86th Ave N
Ste 106
Maple Grove, MN 55369
Phone (952) 300-5908

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1494979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1699202952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11292 86TH AVE N STE 106",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694510",
            "telephone_number": "952-300-5908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11292 86TH AVE N STE 106",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694510",
            "telephone_number": "952-300-5908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "4 COUNSEL, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-17",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "DOTEN",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-300-5908",
        "authorized_official_credential": "MA, LPCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC01429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "4COUNSEL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maple Grove, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.