Individual provider Active NPI

Andrea Leigh Walker

  • Mental Health Counselor
  • White Bear Lake, MN
National Provider Identifier
1790445807
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
4505 White Bear Pkwy Ste 1500
White Bear Lake, MN 55110-3697
Phone
(514) 938-1506
NPI assigned
Dec 30, 2021
Last updated
Dec 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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 Primary

Addresses

Primary practice location

4505 White Bear Pkwy Ste 1500
White Bear Lake, MN 55110-3697

Mailing address

4505 White Bear Pkwy Ste 1500
White Bear Lake, MN 55110-3697
Phone (651) 493-8150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

421 Shumway Ave
Faribault, MN 55021-4415

4505 White Bear Pkwy
Suite 1500
White Bear Lake, MN 55110-3697

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance for Healing PA Mental Health CurrentSince Jan 2, 2022 Accepting new patients

Locations

4505 White Bear Pkwy
Ste 1500
White Bear Lake, MN 55110
Phone (651) 493-8150

Organizations & group practices 1

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": "1640822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1790445807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 WHITE BEAR PKWY STE 1500",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103697",
            "telephone_number": "651-493-8150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 WHITE BEAR PKWY STE 1500",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103697",
            "telephone_number": "514-938-1506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "ANDREA",
        "middle_name": "LEIGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-30",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Bear Lake, MN

Sources for this page

Verify at the official NPI Registry.