Nicole Liv Youngberg, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

3800 Park Nicollet Blvd
Saint Louis Park, MN 55416-2527

Phone

(952) 993-3123

NPI assigned

Oct 26, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Nicole Seehafer Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1063897593
  NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1780621904
  NPD
• Sunnydays Therapy Inc

  • Occupational Therapist
  • Waconia, MN
  • NPI 1891914412
  NPD
• The Lazarus Project

  • Developmentally Disabled Services Day Training Agency
  • Mendota Heights, MN
  • NPI 1003908260
  NPD (past)

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

{
    "created_epoch": "1603670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1841899341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 SHELARD PKWY APT 310",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 PARK NICOLLET BLVD",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554162527",
            "telephone_number": "952-993-3123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2605 Fernbrook Ln N Ste E",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MN",
            "postal_code": "554474736",
            "country_code": "US",
            "telephone_number": "763-519-1197",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2520 Pilot Knob Rd Ste 190",
            "address_purpose": "LOCATION",
            "city": "Mendota Heights",
            "state": "MN",
            "postal_code": "551201152",
            "country_code": "US",
            "telephone_number": "651-452-1500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9346 Oak Ave",
            "address_purpose": "LOCATION",
            "city": "Waconia",
            "state": "MN",
            "postal_code": "553879422",
            "country_code": "US",
            "telephone_number": "952-223-2506",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15265 Minnetonka Blvd",
            "address_purpose": "LOCATION",
            "city": "Minnetonka",
            "state": "MN",
            "postal_code": "553451510",
            "country_code": "US",
            "telephone_number": "952-223-2506",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5232 Kyler Ave NE",
            "address_purpose": "LOCATION",
            "city": "Albertville",
            "state": "MN",
            "postal_code": "553014634",
            "country_code": "US",
            "telephone_number": "952-223-2506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNGBERG",
        "first_name": "NICOLE",
        "middle_name": "LIV",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-26",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sara.wigdahl@sunnydaystherapy.com",
            "affiliation": "N",
            "address_1": "5232 Kyler Ave NE",
            "city": "Albertville",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553014634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "SEEHAFER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nicole Marie Yohn, ST (SURGICAL TECH)
• Jenna Grace Younce
• Brianna Bonnie Young
• Sarah Elizabeth Young, MOT, OTR/L
• Sydney Kaylee Young
• Rebecca Lynn Youngdahl
• Rita J Younger, LICSW
• Benjamin Yun, PHARMD
• Laurea J Yunger
• Asho Said Yussuf

• Occupational Therapist in Saint Louis Park, MN
• Providers in Saint Louis Park, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.