Individual provider Active NPI

Fejzudin Turnadzic, MA, LPCC

  • Mental Health Counselor
  • Brooklyn Center, MN
National Provider Identifier
1891478384
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CC03954 Issued in MN
Practice address
6160 Summit Dr N
Brooklyn Center, MN 55430-2118
Phone
(763) 560-8331
Fax
(763) 560-8431
NPI assigned
Aug 10, 2023
Last updated
Aug 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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 CC03954 MN Primary

Addresses

Primary practice location

6160 Summit Dr N
Brooklyn Center, MN 55430-2118

Mailing address

11136 Fillmore St NE
Blaine, MN 55434-4524
Phone (176) 374-2519

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
I20231221001597 MN Practitioner - Mental Health Counselor 8921458662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Behavioral Health, IncGroup PAC ID 9436287042, 7 clinicians

Practice addresses (Care Compare)

6160 Summit Dr N
Suite 375
Brooklyn Center, MN 55430-2251
Phone 7635608331110

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CC03954MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Behavioral Health, Inc Single Specialty CurrentSince Jan 1, 2024 Accepting new patients

Locations

6160 Summit Dr N
Ste 375
Minneapolis, MN 55430
Phone (763) 560-8331

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, 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": "1691625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1891478384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11136 FILLMORE ST NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554344524",
            "telephone_number": "176-374-2519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6160 SUMMIT DR N",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302118",
            "telephone_number": "763-560-8331",
            "fax_number": "763-560-8431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TURNADZIC",
        "first_name": "FEJZUDIN",
        "credential": "MA, LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-10",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC03954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn Center, MN

Sources for this page

Verify at the official NPI Registry.