Patricia Ann Mandakunis, LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

306870 Issued in MN

Practice address

401 16TH St SE Ste 100
Rochester, MN 55904-7974

Phone

(507) 516-0030

Fax

(507) 516-0031

NPI assigned

Feb 7, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  NPD
• Family Support Services Inc.

  • Mental Health Counselor
  • New Brighton, MN
  • NPI 1467549220
  NPD (past)

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

{
    "created_epoch": "1707264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1851155139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11063 55TH AVE",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337727231",
            "telephone_number": "727-417-2126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 16TH ST SE STE 100",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559047974",
            "telephone_number": "507-516-0030",
            "fax_number": "507-516-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDAKUNIS",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-07",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "306870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Jason Maltagliati, MD
• Akwan Malual
• Megan Drew Malueg, MD
• Grigoriy Malyshev, PA
• Staranne Angelenne Malz
• Meenakshi Mandal, MBBS, MS, MCH
• Krista Mandler, OTR/L
• Marosh Manduch, MD
• Megan Nicole Manento, M.D.
• Martha A Mangan, RN

• Addiction (Substance Use Disorder) Counselor in Rochester, MN
• Providers in Rochester, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.