MARY JUDITH WILLIS LPCC
NPI 1518504620
Counselor - Professional in Minneapolis, MN

Q: What is Mary Willis's NPI number?

The NPI number for Mary Willis is 1518504620. It was assigned to this individual provider in the NPPES registry on December 8, 2019.

Q: What is Mary Willis's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Mary Willis was last updated on October 5, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since December 08, 2019PECOS EnrolledAccepts Medicare Assignment

701 PARK AVE, MINNEAPOLIS, MN 55415(612) 873-6963 Get Directions Write a Review

NPPES record last updated: October 5, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Oct 5, 2023, Dec 8, 2019 (2 updates tracked since 2019).

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About Mary Judith Willis Lpcc NPPES

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

MARY JUDITH WILLIS LPCC (NPI 1518504620) is an individual professional provider in Minneapolis, Minnesota, licensed in Minnesota (2304) and active in the NPI registry since December 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1518504620

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameMARY JUDITH WILLISCredential: LPCC

Location Address701 PARK AVEMinneapolis, MN 55415-1623

Mailing Address701 Park AveMinneapolis, MN 55415-1623 · (612) 873-3000

Phone(612) 873-6963

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateDecember 8, 2019

Last NPPES UpdateOctober 5, 20232 updates tracked since enumeration

NPPES CertifiedOctober 5, 2023

✔ NPI 1518504620 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 · 2304

701 PARK AVE, Minneapolis, MN 55415

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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

Mary Judith Willis 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 ID6901257831

PECOS Enrollment IDI20240104003764

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.

DR. PATRICK ALLEN TESTERMAN MD

Anesthesiology

701 PARK AVE, ANESTHESIA P4
MINNEAPOLIS, MN 55415

Hennepin County (612) 873-3458

MS. CAROL JEAN LUDOWESE MS

Genetic Counselor, MS