MICHELLE MILLENACKER


Address: 3100 W Lake St, Suite 210, Minneapolis, MN 55416-4527
Phone: 6129256033

MICHELLE MILLENACKER (NPI# 1386711729) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1386711729
Entity Type Individual
Full Name MICHELLE MILLENACKER
Credential LP
Practice Address 3100 W Lake St
Suite 210
Minneapolis
MN 55416-4527
Practice Telephone 6129256033
Practice Fax Number 6129258496
Mailing Telephone 6129256033
Mailing Fax Number 6129258496
Enumeration Date 2006-11-29
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TC0700X Psychologist
Specialization: Clinical
LP4246 MN Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
MN MEDICA CHOICE 6121476 01
MN RR MEDICARE P00261483 01
MN BCBS 024L2MA 01
MN BHP 2028301 01
MN HEALTHPARTNERS HP34946 01

Office Location

Street Address 3100 W LAKE ST
SUITE 210
City MINNEAPOLIS
State MN
Zip Code 55416-4527

Providers in the same location

NPI Name Taxonomy Address Enumeration
1417957101 Ronald James Frederick Jr. Psychologist 3100 W Lake St, Suite 107, Minneapolis, MN 55416-4527 2005-07-26
1235665761 Nicole Massey Marriage & Family Therapist 3100 W Lake St, Suite 210, Minneapolis, MN 55416-4527 2017-05-03
1760923940 Lynn Erika Penney Counselor 3100 W Lake St, Suite 210, Minneapolis, MN 55416-4527 2017-03-20
1629526405 Ariel Brinson Social Worker 3100 W Lake St, Suite 210, Minneapolis, MN 55416-4527 2016-09-21
1952855918 Roberta Ann Seelen-wolf Registered Nurse 3100 W Lake St, 210, Minneapolis, MN 55416-4527 2016-08-08
1619420817 Julie Blatz Social Worker 3100 W Lake St, Suite 210, Minneapolis, MN 55416-4527 2016-07-25
1750736708 Kiana Joyner Social Worker 3100 W Lake St, Suite 210, Minneapolis, MN 55416-4527 2016-04-27
1427415082 Natalie Ann Tobeck Social Worker 3100 W Lake St, Suite 210, Minneapolis, MN 55416-4527 2016-01-26
1598132953 Amanda J Ardolf Counselor 3100 W Lake St, Ste 210, Minneapolis, MN 55416-4527 2015-09-01
1578930293 Leeann Catherine Lewis Social Worker 3100 W Lake St, Ste 210, Minneapolis, MN 55416-4527 2015-08-28
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1568897833 Kay Elizabeth Lichtenberger Physical Therapist 4415 W 36.5 St, St. Louis Park, MN 55416 2013-09-05
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Taxonomy Information

Taxonomy Code 103TC0700X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1861008567 Natalia V Potapova Psychologist 701 Park Ave # S1.110, Minneapolis, MN 55415-1623 2020-09-17
1962014167 Kate Esterline Psychologist 2724 University Ave Se Ste B, Minneapolis, MN 55414-3210 2020-08-19
1831740216 Seth Gordon Disner Psychologist 1 Veterans Dr # B68-2, Minneapolis, MN 55417-2309 2019-09-26
1366090763 Healing Therapy LLC Psychologist 1813 S 6th St Ste 201, Minneapolis, MN 55454-1208 2019-08-28
1891340469 Karin Fisher Psychologist 701 Park Ave # S1.260, Minneapolis, MN 55415-1623 2019-08-09
1053881698 Lauren Michelle Scholder Psychologist 401 Main St Se Apt 7009, Minneapolis, MN 55414 2018-11-27
1902306038 Ksa Psychological Services, LLC Psychologist 5603 Chicago Ave., Minneapolis, MN 55417 2018-02-15
1689030231 Oliver Ross Psychology and Consulting LLC Psychologist 3802 Grand Ave S, Suite A, Minneapolis, MN 55409-1233 2016-01-13
1295100881 Oliver Ross Psychologist 3802a Grand Avenue South, Minneapolis, MN 55409 2015-12-08
1841664190 Lakes Wellness Center LLC Psychologist 3248 Stevens Ave, Minneapolis, MN 55408-3214 2015-11-24
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Competitor

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City MINNEAPOLIS
Zip Code 55416

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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