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NPI Code Detail

MEDICARE: CHOICES PSYCHOTHERAPY, LTD.

MEDICARE: CHOICES PSYCHOTHERAPY, LTD.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
2101YP2500XProfessional Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
27500691OTHERMNAETNA GROUP
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
45G669DAOTHERMNBCBS LICSW GROUP ID
5620S7CHOTHERMNBCBS LMFT
6312P4CHOTHERMNBCBS LP GROUP ID
7804356000OTHERMNMAGELLEN GROUP ID

General Provider Information

NPI Number : 1134171127
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHOICES PSYCHOTHERAPY, LTD.
Provider Business Mailing Address
First Line : 10201 WAYZATA BLVD STE 100
Second Line :
City : MINNETONKA
State : MN
Zip : 55305-1500
Country : US
Telephone Number : 952-544-6806
Fax Number : 952-545-0098
Provider Business Practice Location Address
First Line : 10201 WAYZATA BLVD STE 100
Second Line :
City : MINNETONKA
State : MN
Zip : 55305-1500
Country : US
Telephone Number : 952-544-6806
Fax Number : 952-545-0098
Authorized Official
Title or Position : CLINICAL DIRECTOR
Name : RACHEL M MORAN
Credential : LMFT
Telephone Number : 952-544-6806
Provider Enumeration Date : 05/17/2006
Last Update Date : 06/10/2026

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Directions to “CHOICES PSYCHOTHERAPY, LTD. ” Practice Location

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