Angela Suzanne Elmendorf
NPI 1073165569ActiveIndividual· Counselor, Professional· Chanhassen, MN
Counselor, Professional in Chanhassen, Minnesota, licensed in MN, with an NPI issued in July 2019. Enrolled in Medicare as practitioner - mental health counselor.
Overview
| NPI | 1073165569 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Jul 15, 2019 |
| Last updated in NPPES | Jul 2, 2026 |
| Certified by provider | Jul 2, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor, Professional Primary | 101YP2500X | 5503 | MN |
| Behavior Technician | 106S00000X | — | — |
| Counselor, Mental Health | 101YM0800X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Mental Health Counselor (MN) |
|---|
Education and affiliations
| Graduation year | 2022 |
|---|---|
| Medicare specialty | Mental Health Counselor |
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