Laura Anderson
Individual provider Active NPI Professional Counselor · Eden Prairie, MN
NPI 1962706887 · NPPES record last updated Jan 6, 2011
Key facts
- NPI
- 1962706887
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- CC00185 (MN)
- Practice address
- 11010 Prairie Lakes Dr
Suite 250
Eden Prairie, MN 55344-3884 - Phone
- (952) 746-2522
- NPI assigned
- Jan 6, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Vantage Mental Health
Practice addresses (Care Compare)
7401 Metro Blvd
Suite 425
Edina, MN 55439-3011
Phone (651) 217-1480
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240425003624 | MN | Practitioner - Mental Health Counselor | 7618317561 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CC00185 | MN | MD | Professional Counselor |
| 185 | MN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vantage Mental Health | Current |
Accepting new patients | |
| Nystrom & Associates, LTD | Current |
Accepting new patients | |
| Collaborative Psychiatric Services LLC | Past |
Accepting new patients |
Locations
7401 Metro Blvd
Ste 425
Edina, MN 55439
Phone (651) 217-1480
1370 Mendota Heights Rd
Mendota Heights, MN 55120
Phone (651) 583-4447
6040 Earle Brown Dr
Ste 100
Minneapolis, MN 55430
Phone (612) 470-4576
1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718
1150 Montreal Ave
Ste 107
Saint Paul, MN 55116
Phone (651) 303-8080
5995 Oren Ave N
Ste 203
Stillwater, MN 55082
Phone (651) 217-1480
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | CC00185 | MN | Yes |
Addresses
Primary practice location
11010 Prairie Lakes Dr
Suite 250
Eden Prairie, MN 55344-3884
Mailing address
1900 Silver Lake Rd NW
Suite 110
New Brighton, MN 55112-1786
Other providers in Eden Prairie, MN
- David Anderson
- Isabelle Rayne Anderson
- James Stanley Anderson
- John Mayo Anderson
- Joshua Charles Anderson
- Qamar Bilaal Andrews
- Angel Home Care
- Angel Preferred Care LLC
- Michael James Annen
- Shaelyn Annunziata
All providers in Eden Prairie, MN · Professional Counselor in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 6, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.