Active NPI 1205229358 Individual Practitioner Male Practitioner

Mitchell Marc Tavernier , MA, LPCC

Counselor - Professional • Minneapolis, MN

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Mitchell Tavernier, MA, LPCC is a certified Counselor - Professional practicing in Minneapolis, MN. With approximately 14 years of clinical experience since completing medical education in 2012, Mitchell Tavernier delivers high-quality medical care to the local community at 4027 COUNTY ROAD 25.

Mitchell Tavernier is affiliated with Associated Clinic Of Psychology Inc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Practice Location & Contact Primary Location

Practice Address

4027 County Road 25

Minneapolis, MN 554162629

Telephone 6129256033

Fax 6129258496

Associated Practice Facility / Clinic

🏢 Associated Clinic Of Psychology Inc Facility NPI 1588741292

Medicare Profile & Education

Medical School

Other

Graduation Year

2012

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Minneapolis, MN

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

14 Yrs +3.2 yrs vs City Avg

City Avg: 10.8 Yrs

State Avg: 11.4 Yrs

Regional Practice Density

328 Specialists

Practicing in Minneapolis, MN (2422 Statewide)

Telehealth Adoption Rate

12.5% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Tavernier (14 Years) 14 Yrs

Minneapolis Specialty Average (10.8 Years) 10.8 Yrs

Medical Specialties & State Licenses

CMS Verified: 2023-12-13

Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License MN 948

Definition to come...

Hospital & Practice Group Affiliations

Associated Clinic Of Psychology Inc

4027 County Rd, St Louis Park, MN 554164119

Phone: 6129256033

Secondary Practice Locations

1155 Ford Rd Ste B

St Louis Park, MN 554261115

Phone: 9523781800

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners

Alex Hoyt , MSW, LICSW

Social Worker - Clinical

NPI 1003530734

Master of Social Work, Licensed Independent Clinical Social Worker

Dr. Diane Stellrecht , PhD, LP

Psychologist - Clinical

NPI 1013108075

Doctor of Philosophy (Ph.D.), Licensed Psychologist

Sarah Najafalipour , MA, LPCC

Counselor - Professional

NPI 1013534817

Master of Arts, Licensed Professional Clinical Counselor

Leslie Wise , MS, LPCC

Counselor - Professional

NPI 1013615145

Master of Science, Licensed Professional Clinical Counselor

Breanna Freeborn , MA, LPCC

Counselor - Professional

NPI 1023533627

Master of Arts, Licensed Professional Clinical Counselor

James Moore , LP

Psychologist - Clinical

NPI 1033286489

Licensed Psychologist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events

📍

Updated Practice Location December 13, 2023

Registered at 4027 COUNTY ROAD 25, MINNEAPOLIS, MN 554162629 (Tel: 6129256033)

📍

Updated Business Mailing Address December 13, 2023

Registered at 4240 PARK GLEN RD, ST LOUIS PARK, MN 554165427 (Tel: 6129256033)

✅

NPI Profile Active March 13, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location March 13, 2015

Registered at 3100 W LAKE ST, STE 210, MINNEAPOLIS, MN 554164527 (Tel: 6129256033)

📍

Updated Business Mailing Address March 13, 2015

Registered at 3100 W LAKE ST, STE 210, MINNEAPOLIS, MN 554164527 (Tel: 6129256033)

👤

Provider Name / Credentials Updated March 13, 2015

Recorded as MITCHELL TAVERNIER, MA, LPCC

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 13, 2015

Counselor (License #948 in MN)

🟢

Initial NPI Registration & Enumeration March 13, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1205229358

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: March 13, 2015

Last Update: December 13, 2023

Sole Proprietor: No

Update or Correct Profile

Mailing Address

4240 Park Glen Rd

St Louis Park, MN 554165427

Phone: 6129256033

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.