MITCHELL MARC TAVERNIER MA, LPCC
NPI 1205229358
Counselor - Professional in Minneapolis, MN

Q: What is Mitchell Tavernier's NPI number?

The NPI number for Mitchell Tavernier is 1205229358. It was assigned to this individual provider in the NPPES registry on March 13, 2015.

Q: What is Mitchell Tavernier's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Active since March 13, 2015PECOS EnrolledAccepts Medicare Assignment

4027 COUNTY ROAD 25, MINNEAPOLIS, MN 55416(612) 925-6033(612) 925-8496 Get Directions Write a Review

NPPES record last updated: December 13, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Mitchell Marc Tavernier Ma, Lpcc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MITCHELL MARC TAVERNIER MA, LPCC (NPI 1205229358) is an individual professional provider in Minneapolis, Minnesota, licensed in Minnesota (948) and active in the NPI registry since March 2015. He is enrolled in Medicare PECOS, maintains a secondary practice location in St Louis Park, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1205229358

Entity TypeIndividualMale

Primary Taxonomy101YP2500X

Provider Legal NameMITCHELL MARC TAVERNIERCredential: MA, LPCC

Location Address4027 COUNTY ROAD 25Minneapolis, MN 55416-2629

Mailing Address4240 Park Glen RdSt Louis Park, MN 55416-5427 · (612) 925-6033 · Fax (612) 925-8496

Phone(612) 925-6033

Fax(612) 925-8496

Sole ProprietorNo

Medical School CMSOtherGraduated 2012

Enumeration DateMarch 13, 2015

Last NPPES UpdateDecember 13, 2023

NPPES CertifiedDecember 13, 2023

✔ NPI 1205229358 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in MN · 948

4027 COUNTY ROAD 25, Minneapolis, MN 55416

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Secondary Practice Location 1

Location 11155 Ford Rd Ste BSt Louis Park, MN 55426-1115 · Phone (952) 378-1800 · Fax (952) 378-1714

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mitchell Marc Tavernier Ma, Lpcc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9436592110

PECOS Enrollment IDI20240209001122

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FLOYD OWEN ANDERSON MD

Psychiatry & Neurology (Psychiatry)