Individual provider Active NPI

Anne Caroline Mitsch, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Maplewood, MN
National Provider Identifier
1811622384
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
518153 Issued in MN
Practice address
2395 Ariel St N Ste B
Maplewood, MN 55109-2248
Phone
(651) 773-3208
NPI assigned
Jul 19, 2022
Last updated
Jul 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 518153 MN Primary

Addresses

Primary practice location

2395 Ariel St N Ste B
Maplewood, MN 55109-2248

Mailing address

12882 Essex Way
Apple Valley, MN 55124-4501
Phone (952) 463-5773

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221102003338 MN Practitioner - Qualified Speech Language Pathologist 8426425554 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
518153MNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Speech and Language Specialists LLC Speech-Language Pathologist CurrentSince Sep 1, 2022 Accepting new patients
Associated Speech and Language Past Accepting new patients

Locations

3021 Harbor Ln N
Ste 120
Plymouth, MN 55447
Phone (651) 773-0354

2395 Ariel St N
#B
Saint Paul, MN 55109
Phone (651) 773-3208

561 7th St W
Saint Paul, MN 55102
Phone (651) 225-4558

6 Pine Tree Dr
Ste 330
Saint Paul, MN 55112
Phone (651) 639-0942

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": "1658188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1811622384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12882 ESSEX WAY",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551244501",
            "telephone_number": "952-463-5773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2395 ARIEL ST N STE B",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551092248",
            "telephone_number": "651-773-3208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITSCH",
        "first_name": "ANNE",
        "middle_name": "CAROLINE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-19",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "518153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.