Individual provider Active NPI

Judy Marie Lavone, M.A., LPCC

  • Mental Health Counselor
  • Minneapolis, MN
National Provider Identifier
1710310438
Registry record updated Aug 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
628 Issued in MN
Practice address
3100 W Lake St
Suite 210
Minneapolis, MN 55416-4527
Phone
(612) 925-6033
Fax
(612) 925-8496
NPI assigned
Aug 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 628 MN Primary

Addresses

Primary practice location

3100 W Lake St
Suite 210
Minneapolis, MN 55416-4527

Mailing address

3100 W Lake St
Suite 210
Minneapolis, MN 55416-4527
Phone (612) 925-6033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240426002964 MN Practitioner - Mental Health Counselor 5799137675 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
628MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Tamera Mensink TM Counseling LLC CurrentSince Mar 16, 2024 Accepting new patients
Associated Clinic of Psychology Inc PastSince Jul 31, 2006 Accepting new patients

Locations

7600 143rd St W
Ste 300
Apple Valley, MN 55124
Phone (651) 373-9440

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1376611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376611200000",
    "number": "1710310438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 W LAKE ST",
            "address_2": "SUITE 210",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164527",
            "telephone_number": "612-925-6033",
            "fax_number": "612-925-8496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 W LAKE ST",
            "address_2": "SUITE 210",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164527",
            "telephone_number": "612-925-6033",
            "fax_number": "612-925-8496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVONE",
        "first_name": "JUDY",
        "middle_name": "MARIE",
        "credential": "M.A., LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-16",
        "last_updated": "2013-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.