Individual provider Active NPI

Rachel Nycklemoe Christopher, MPS, LPCC

  • Mental Health Counselor
  • Minneapolis, MN
National Provider Identifier
1922728559
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CC03423 Issued in MN
Practice address
4208 Park Glen Rd
Minneapolis, MN 55416-4758
Phone
(612) 756-8064
NPI assigned
Sep 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 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 CC03423 MN Primary

Addresses

Primary practice location

4208 Park Glen Rd
Minneapolis, MN 55416-4758

Mailing address

2901 Hampshire Ave N
Crystal, MN 55427-3031

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
I20241122000090 MN Practitioner - Mental Health Counselor 8325573751 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CC03423MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
CGC LLC CurrentSince Oct 1, 2024 Accepting new patients

Locations

333 Washington Ave N
Minneapolis, MN 55401
Phone (612) 349-2797

4208 Park Glen Rd
St Louis Park, MN 55416
Phone (612) 825-4792

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": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1922728559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 HAMPSHIRE AVE N",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554273031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4208 PARK GLEN RD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164758",
            "telephone_number": "612-756-8064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTOPHER",
        "first_name": "RACHEL",
        "middle_name": "NYCKLEMOE",
        "credential": "MPS, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-01",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC03423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.