Individual provider Active NPI

Mary Rose Colucci, MA, LAMFT

  • Mental Health Counselor
  • Golden Valley, MN
National Provider Identifier
1811513286
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
8401 Wayzata Blvd Ste 150
Golden Valley, MN 55426-1377
Phone
(763) 544-1006
NPI assigned
Jun 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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

8401 Wayzata Blvd Ste 150
Golden Valley, MN 55426-1377

Mailing address

8401 Wayzata Blvd Ste 150
Golden Valley, MN 55426-1377

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
I20240620000269 MN Practitioner - Marriage and Family Therapist 3274076153 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3967MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Hoy & Associates Inc. CurrentSince May 1, 2024 Accepting new patients

Locations

8401 Wayzata Blvd
Ste 150
Minneapolis, MN 55426
Phone (763) 544-1006

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1592784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1811513286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 WAYZATA BLVD STE 150",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554261377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 WAYZATA BLVD STE 150",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554261377",
            "telephone_number": "763-544-1006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLUCCI",
        "first_name": "MARY",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "MA, LAMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-22",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

Verify at the official NPI Registry.