Individual provider Active NPI

Amber Schupp, M.A., LPCC

  • Mental Health Counselor
  • Bloomington, MN
National Provider Identifier
1720215171
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CC00894 Issued in MN
Practice address
10800 Lyndale Ave S Ste 350
Bloomington, MN 55420-5648
Phone
(651) 689-3012
NPI assigned
Jun 12, 2009
Last updated
Apr 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CC00894 MN Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

10800 Lyndale Ave S Ste 350
Bloomington, MN 55420-5648

Mailing address

3872 Kennet Cir
Eagan, MN 55123-3952
Phone (651) 271-9088

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
I20240131002769 MN Practitioner - Mental Health Counselor 7012369085 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Emberly Mental Health and Wellness PLLCGroup PAC ID 1658848221, 2 clinicians
Eagan Counseling ClinicGroup PAC ID 2860304045, 62 clinicians

Practice addresses (Care Compare)

10800 Lyndale Ave S
Suite 350
Bloomington, MN 55420-5648
Phone (651) 689-3012

3450 Oleary LN
Eagan, MN 55123-2340
Phone (651) 454-0114

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emberly Mental Health & Wellness PLLC Mental Health CurrentSince Apr 1, 2026 Accepting new patients

Locations

10800 Lyndale Ave S
Ste 350
Bloomington, MN 55420
Phone (651) 689-3012

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1244764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1720215171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3872 KENNET CIR",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551233952",
            "telephone_number": "651-271-9088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10800 LYNDALE AVE S STE 350",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554205648",
            "telephone_number": "651-689-3012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUPP",
        "first_name": "AMBER",
        "credential": "M.A., LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-12",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC00894",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.