Active NPI
Paul Gregory Fleckenstein
- Mental Health Counselor
- Duluth, MN
National Provider Identifier
1962707950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 1000-125
- Practice address
- 4000 W 9TH St
Duluth, MN 55807-1563 - Phone
- (218) 628-0237
- Fax
- (651) 323-2184
- NPI assigned
- Jan 21, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2221-123 | WI | |
| Mental Health Counselor | 101YM0800X | 1000-125 | WI | Primary |
Addresses
Primary practice location
4000 W 9TH St
Duluth, MN 55807-1563
Mailing address
4000 W 9TH St
Duluth, MN 55807-1563
Phone (218) 628-0237
Other practice location 1
1419 Hill Ave
Suite 1419
Superior, WI 54880-1951
Phone (715) 395-3805
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1000-125 | WI | MD | Mental Health Counselor |
| 2221-123 | WI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525737600000",
"number": "1962707950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4000 W 9TH ST",
"city": "DULUTH",
"state": "MN",
"postal_code": "558071563",
"telephone_number": "218-628-0237",
"fax_number": "651-323-2184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4000 W 9TH ST",
"city": "DULUTH",
"state": "MN",
"postal_code": "558071563",
"telephone_number": "218-628-0237",
"fax_number": "651-323-2184"
}
],
"practiceLocations": [
{
"address_1": "1419 Hill Ave",
"address_2": "Suite 1419",
"address_purpose": "LOCATION",
"city": "Superior",
"state": "WI",
"postal_code": "548801951",
"country_code": "US",
"telephone_number": "715-395-3805",
"fax_number": "715-395-3807",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FLECKENSTEIN",
"first_name": "PAUL",
"middle_name": "GREGORY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-01-21",
"last_updated": "2018-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "2221-123",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WI",
"license": "1000-125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Duluth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.