Peggy Martin, LPCC
Individual provider Active NPI Mental Health Counselor · Loretto, MN
NPI 1992109540 · NPPES record last updated Oct 10, 2014
Key facts
- NPI
- 1992109540
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- CC00869 (MN)
- Practice address
- 3675 Ihduhapi Rd
Loretto, MN 55357-2120 - Phone
- (763) 479-3555
- Fax
- (763) 479-2605
- NPI assigned
- Oct 10, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Vinland National Center
Practice addresses (Care Compare)
3675 Ihduhapi Rd
Loretto, MN 55357-2120
Phone (763) 479-3555
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 |
|---|---|---|---|---|
| I20240219003155 | MN | Practitioner - Mental Health Counselor | 0244681088 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CC00869 | MN | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vinland National Center | Current |
Accepting new patients | |
| Karol, PC | Past |
Accepting new patients |
Locations
3675 Ihduhapi Rd
Loretto, MN 55357
Phone (763) 479-3555
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CC00869 | MN | Yes |
Addresses
Primary practice location
3675 Ihduhapi Rd
Loretto, MN 55357-2120
Mailing address
3675 Ihduhapi Rd
Loretto, MN 55357-2120
Phone (763) 479-3555
Other providers in Loretto, MN
- Mark Thomas Collins
- Megan Grunerud
- Angie Hyde
- Brian William Kolling
- Ricki Gene Krueger
- Marlo Rebecca McGregor-Michael
- Kaija Michelle Muhich
- Grace Palubicki
- Richard C Axel, DDS, PA
- Jerry Jack Robb
All providers in Loretto, MN · Mental Health 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 Oct 10, 2014. 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.