LAKE MINNETONKA COUNSELING NPI 1578835310

NPI Information

NPI: 1578835310
Provider Name: LAKE MINNETONKA COUNSELING
Classification: Clinic/Center - 261QM0855X
Specialization: Adolescent and Children Mental Health
Entity Type: Organization
Address: 432 MILL ST
SUITE 201
LONG LAKE, MN
ZIP 55356
Phone: (612) 386-2311

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NPI Details

LAKE MINNETONKA COUNSELING is an adolescent and children mental health clinic center in Long Lake, MN. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. LAKE MINNETONKA COUNSELING NPI is 1578835310. The provider is registered as an organization entity type.

The provider's business location address is:

432 MILL ST
SUITE 201
LONG LAKE, MN
ZIP 55356-304
Phone: (612) 386-2311

The provider's authorized official is Tara Marie Bauman .
The authorized official title is Therapist and has the following contact phone number (612) 386-2311.

The enumeration date for this NPI number is 2/8/2012 and was last updated on 2/8/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0850X	Clinic/Center	Adult Mental Health	18016	MINNESOTA	No
2	261QM0855X	Clinic/Center	Adolescent and Children Mental Health	18016	MINNESOTA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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