NPIMap

Organization Active NPI

Indigo Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Paul, MN
National Provider Identifier
1699249342
Registry record updated Jan 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
INDIGO COUNSELING CENTER
Practice address
2388 University Ave W # 202
Saint Paul, MN 55114-1769
Phone
(612) 293-5124
Fax
(651) 300-2702
NPI assigned
Jan 16, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2019

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

Authorized official

Name
Joan D Hause, LPCCNPI 1710250832
Title
Licensed Counselor
Phone
(612) 293-5128

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 Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

2388 University Ave W # 202
Saint Paul, MN 55114-1769

Mailing address

2388 University Ave W # 202
Saint Paul, MN 55114-1769
Phone (612) 293-5124

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250908002992 MN Part B Supplier - Clinic/Group Practice 3274035217 Receives reassigned benefits from 4 practitioners
Practice locations: Saint Paul, MN

National Provider Directory

National Provider Directory

Locations

2388 University Ave W
#202
Saint Paul, MN 55114
Phone (612) 293-5124

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1547596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547596800000",
    "number": "1699249342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2388 UNIVERSITY AVE W # 202",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141769",
            "telephone_number": "612-293-5124",
            "fax_number": "651-300-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2388 UNIVERSITY AVE W # 202",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141769",
            "telephone_number": "612-293-5124",
            "fax_number": "651-300-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIGO COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-16",
        "last_updated": "2019-01-16",
        "status": "A",
        "authorized_official_last_name": "HAUSE",
        "authorized_official_first_name": "JOAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "LICENSED COUNSELOR",
        "authorized_official_telephone_number": "612-293-5128",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; 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.