NPIMap

Organization Active NPI

Lakes Counseling Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Minneapolis, MN
National Provider Identifier
1700359874
Registry record updated May 3, 2025
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
LAKES COUNSELING SERVICES LLC
Practice address
121 Hennepin Ave
Minneapolis, MN 55401-1802
Phone
(612) 412-3318
Fax
(612) 288-1805
NPI assigned
Jan 10, 2019
Last updated
May 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2025

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

Authorized official

Name
Intisar Omar Hussein, MSW LICSWNPI 1235613597
Title
President
Phone
(612) 412-3318

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Early Intervention Provider Agency 252Y00000X

Addresses

Primary practice location

121 Hennepin Ave
Minneapolis, MN 55401-1802

Mailing address

121 Hennepin Ave
Minneapolis, MN 55401-1802
Phone (612) 412-3318

Other practice location 1

4640 Slater Rd
Eagan, MN 55122-4043
Phone (612) 412-3318

National Provider Directory

National Provider Directory
Tax ID family
Lakes Counseling Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4640 Slater Rd
Eagan, MN 55122
Phone (612) 412-3318

121 Hennepin Ave
Minneapolis, MN 55401
Phone (612) 354-2424

1600 Broadway St NE
Ste 200
Minneapolis, MN 55413
Phone (612) 236-4956

Practitioners & affiliated clinicians

Practitioners 85

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.

View all 85

NPI Registry JSON

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

{
    "created_epoch": "1547078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746230400000",
    "number": "1700359874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 HENNEPIN AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554011802",
            "telephone_number": "612-412-3318",
            "fax_number": "612-288-1805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 HENNEPIN AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554011802",
            "telephone_number": "612-412-3318",
            "fax_number": "612-288-1805"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4640 Slater Rd",
            "address_purpose": "LOCATION",
            "city": "Eagan",
            "state": "MN",
            "postal_code": "551224043",
            "country_code": "US",
            "telephone_number": "612-412-3318",
            "fax_number": "612-288-1805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LAKES COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-10",
        "last_updated": "2025-05-03",
        "certification_date": "2025-05-03",
        "status": "A",
        "authorized_official_last_name": "HUSSEIN",
        "authorized_official_first_name": "INTISAR",
        "authorized_official_middle_name": "OMAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-412-3318",
        "authorized_official_credential": "MSW LICSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.