Brittni Amanda Ingvaldson

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

04654 Issued in MN

Practice address

17645 Juniper Path Ste 105
Lakeville, MN 55044-7491

Phone

(952) 600-8191

NPI assigned

Aug 8, 2021

Last updated

Dec 6, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Soulfully Rewritten Therapy

  • Mental Health Counselor
  • Eden Prairie, MN
  • NPI 1699570713

  Addiction (Substance Use Disorder)

  Medicare reassignment NPD Authorized official
• Ellie Family Services, PLLP

  dba Ellie Mental Health

  • Community/Behavioral Health Agency
  • Mendota Heights, MN
  • NPI 1740664150
  NPD
• Serenity Behavioral Health & Wellness LLC

  • Clinical Psychologist
  • Savage, MN
  • NPI 1750999546

  Adult Mental Health

  NPD (past)

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

{
    "created_epoch": "1628380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1922772383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5241 LINCOLN DR APT 113",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554362701",
            "telephone_number": "507-363-1672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17645 JUNIPER PATH STE 105",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550447491",
            "telephone_number": "952-600-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGVALDSON",
        "first_name": "BRITTNI",
        "middle_name": "AMANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-08",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "304240",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "04654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hy-Vee Health PC
• Hy-Vee Inc (Hy-Vee Pharmacy (1356))
• Osman Noor Ibrahim
• Ramla Ibrahim
• Independent School District # 194
• Chelsea Inskeep
• Joel Inskeep
• Integra Health Care, Inc.
• Integra Home Care, Inc.
• Integrate Therapy LLC

• Professional Counselor in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.