Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mitchell Marc Tavernier, MA, LPCC

Individual provider Professional Counselor · NPI 1205229358

Mitchell Marc Tavernier, MA, LPCC is a Mental Health Counselor in Minneapolis, Minnesota. Qualified in 2012, 14 years ago. Practices with Associated Clinic of Psychology Inc, a 137-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
14
Licensed in
MN
In the registry since
2015
What do these letters mean?
MA — Master of Arts
A graduate arts degree.
LPCC — Licensed Professional Clinical Counselor
The title some states use for a licensed clinical counsellor.

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Practice location Address checks out

4027 County Road 25
Minneapolis, MN 55416-2629
Phone: (612) 925-6033
Fax: (612) 925-8496
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1155 Ford Rd Ste B, St Louis Park, MN 55426-1115 — (952) 378-1800

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 948 (MN)

Record details

NPI number1205229358
Entity typeIndividual (Type 1)
GenderMale
Credentials MA , LPCC
Sole proprietorNo
NPI enumeratedMarch 13, 2015
Last updated in NPPESDecember 13, 2023
Certification dateDecember 13, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Associated Clinic Of Psychology Inc — 137 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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