Individual provider Active NPI

Tiffany R. Pirkl, MA, LPCC

  • Mental Health Counselor
  • Bloomington, MN
National Provider Identifier
1851099295
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CC04788 Issued in MN
Practice address
3601 Minnesota Dr Ste 170
Bloomington, MN 55435-5202
Phone
(952) 299-6949
NPI assigned
Feb 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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 CC04788 MN Primary

Addresses

Primary practice location

3601 Minnesota Dr Ste 170
Bloomington, MN 55435-5202

Mailing address

2230 Hidden Valley Rd Apt 87
Northfield, MN 55057-3136
Phone (763) 339-5819

Other identifiers 1

IdentifierTypeStateIssuer
251S00000XMedicaidMN

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
I20260313000262 MN Practitioner - Mental Health Counselor 9436632874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

570 Professional Dr
Northfield, MN 55057-2756

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CC04788MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Secure Base Counseling Center LLC CurrentSince Feb 1, 2026 Accepting new patients

Locations

301 Main St E
New Prague, MN 56071
Phone (612) 758-4431

570 Professional Dr
Northfield, MN 55057
Phone (507) 301-3412

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": "1676419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1851099295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 HIDDEN VALLEY RD APT 87",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550573136",
            "telephone_number": "763-339-5819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 MINNESOTA DR STE 170",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554355202",
            "telephone_number": "952-299-6949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIRKL",
        "first_name": "TIFFANY",
        "middle_name": "R.",
        "credential": "MA, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-15",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC04788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251S00000X",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.