Individual provider Active NPI

Chad Andrew Talbot, LPCC

  • Professional Counselor
  • Maple Grove, MN
National Provider Identifier
1962011635
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4297 Issued in MN
Practice address
9325 Upland LN N Ste 210
Maple Grove, MN 55369-5777
Phone
(612) 915-0049
NPI assigned
Jul 28, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X 4297 MN Primary

Addresses

Primary practice location

9325 Upland LN N Ste 210
Maple Grove, MN 55369-5777

Mailing address

19591 Station St Apt 308
Big Lake, MN 55309-9436
Phone (612) 242-2519

Other practice location 1

19564 Station St Apt 305
Big Lake, MN 55309-3802
Phone (612) 242-2519

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
I20250512002293 MN Practitioner - Mental Health Counselor 7911424056 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Innovations, Inc. Professional CurrentSince Apr 7, 2025 Accepting new patients
West Central Counseling LLC Mental Health PastSince Jun 6, 2021 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

121 5th Ave W
Alexandria, MN 56308
Phone (320) 759-3096

1833 3rd Ave
Anoka, MN 55303
Phone (763) 421-5535

9325 Upland Ln N
Ste 210
Maple Grove, MN 55369
Phone (612) 453-4966

Organizations & group practices 2

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": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1962011635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19591 STATION ST APT 308",
            "city": "BIG LAKE",
            "state": "MN",
            "postal_code": "553099436",
            "telephone_number": "612-242-2519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9325 UPLAND LN N STE 210",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553695777",
            "telephone_number": "612-915-0049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19564 Station St Apt 305",
            "address_purpose": "LOCATION",
            "city": "Big Lake",
            "state": "MN",
            "postal_code": "553093802",
            "country_code": "US",
            "telephone_number": "612-242-2519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TALBOT",
        "first_name": "CHAD",
        "middle_name": "ANDREW",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-28",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "4297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.