Individual provider Active NPI

Tyler Robert Rekowski, LPCC

  • Counselor
  • Minnetonka, MN
National Provider Identifier
1801436688
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
CC02273 Issued in MN
Practice address
2828 Jordan Ave S Apt 202
Minnetonka, MN 55305-3504
Phone
(715) 651-4115
NPI assigned
Jan 9, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2024

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 7848-125 WI
Counselor 101Y00000X CC02273 MN Primary

Addresses

Primary practice location

2828 Jordan Ave S Apt 202
Minnetonka, MN 55305-3504

Mailing address

2828 Jordan Ave S Apt 202
Minnetonka, MN 55305-3504
Phone (651) 728-6400

Other practice location 1

500 Marschall Rd Ste 100
Shakopee, MN 55379-2689
Phone (952) 448-6557

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CC02273MNMDCounselor
7848-125WIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Compassion Clinic Therapy Services PLLC Mental Health CurrentSince Jan 14, 2024 Accepting new patients
Northstar Regional Past Accepting new patients
Northstar Regional Past Accepting new patients
Familymeans Mental Health PastSince Jan 1, 2020 Accepting new patients

Organizations & group practices 4

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": "1578528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1801436688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 JORDAN AVE S APT 202",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553053504",
            "telephone_number": "651-728-6400",
            "fax_number": "952-448-6047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 JORDAN AVE S APT 202",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553053504",
            "telephone_number": "715-651-4115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Marschall Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Shakopee",
            "state": "MN",
            "postal_code": "553792689",
            "country_code": "US",
            "telephone_number": "952-448-6557",
            "fax_number": "952-448-6047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REKOWSKI",
        "first_name": "TYLER",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-09",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "7848-125",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MN",
            "license": "CC02273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.