Individual provider Active NPI

Isaac Roy Hatch-Gillette, LPCC

  • Professional Counselor
  • Saint Paul, MN
National Provider Identifier
1770256505
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4726 Issued in MN
Practice address
7300 147TH St W
Saint Paul, MN 55124-7541
Phone
(952) 997-3020
NPI assigned
Jul 28, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 4726 MN Primary

Addresses

Primary practice location

7300 147TH St W
Saint Paul, MN 55124-7541

Mailing address

1900 Silver Lake Rd NW Ste 110
New Brighton, MN 55112-1789
Phone (651) 628-9566

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
I20241213003296 MN Practitioner - Mental Health Counselor 0941736946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians

Practice addresses (Care Compare)

7300 147TH St W
Suite 600
Apple Valley, MN 55124-7850
Phone (952) 997-3020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4726MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates, LTD CurrentSince Dec 1, 2024 Accepting new patients
Family Support Services Inc. Mental Health PastSince Dec 1, 2024 Accepting new patients

Locations

7300 147th St W
Ste 600
Apple Valley, MN 55124
Phone (952) 997-3020

6600 France Ave S
Ste 425
Edina, MN 55435
Phone (952) 243-8300

17685 Juniper Path
Ste 303
Lakeville, MN 55044
Phone (952) 214-8959

1101 E 78th St
Ste 100
Minneapolis, MN 55420
Phone (952) 234-8604

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

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": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1770256505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW STE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121789",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 147TH ST W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551247541",
            "telephone_number": "952-997-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATCH-GILLETTE",
        "first_name": "ISAAC",
        "middle_name": "ROY",
        "name_prefix": "Mr.",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-28",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "4726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.