Peggy Martin, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC00869 Issued in MN

Practice address

3675 Ihduhapi Rd
Loretto, MN 55357-2120

Phone

(763) 479-3555

Fax

(763) 479-2605

NPI assigned

Oct 10, 2014

Last updated

Oct 10, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Specialty

Mental Health Counselor

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vinland National CenterGroup PAC ID 1557516184, 7 clinicians

Practice addresses (Care Compare)

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.

• Vinland National Center

  • Substance Abuse Rehabilitation Facility
  • Loretto, MN
  • NPI 1144329632
  Medicare reassignment Care Compare group NPD
• Karol, PC

  dba Karol Neuropsychological Services & Consulting

  • Clinical Neuropsychologist
  • Eden Prairie, MN
  • NPI 1053383679
  NPD (past)

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

{
    "created_epoch": "1412899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412899200000",
    "number": "1992109540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3675 IHDUHAPI RD",
            "city": "LORETTO",
            "state": "MN",
            "postal_code": "553572120",
            "telephone_number": "763-479-3555",
            "fax_number": "763-479-2605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3675 IHDUHAPI RD",
            "city": "LORETTO",
            "state": "MN",
            "postal_code": "553572120",
            "telephone_number": "763-479-3555",
            "fax_number": "763-479-2605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "PEGGY",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-10",
        "last_updated": "2014-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC00869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Thomas Collins, MA, LPCC, LADC
• Megan Grunerud, OTR/L
• Angie Hyde, LPCC
• Brian William Kolling, PHARMD
• Ricki Gene Krueger, MA, LPC, LADC
• Marlo Rebecca McGregor-Michael
• Kaija Michelle Muhich
• Grace Palubicki, DR.
• Richard C Axel, DDS, PA
• Jerry Jack Robb

• Mental Health Counselor in Loretto, MN
• Providers in Loretto, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.