MAX RICHARD STOLTENBERG (MC, LPCC) – Counselor, NPI 1184870610

MAX RICHARD STOLTENBERG (MC, LPCC) is a healthcare provider. based in Crystal, Minnesota. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MC, LPCC. They hold a License No. 3699 (MN). The NPI Number for MAX RICHARD STOLTENBERG (MC, LPCC) is 1184870610

Main info

Male
Sole Proprietor
26 Years Of Experience
Accepts Medicare Assignment
Name
MAX RICHARD STOLTENBERG (MC, LPCC)
NPI
1184870610
Phone
(763) 330-2774
Address
5700 BOTTINEAU BLVD STE 210
Enumeration Date
15 August 2008
Last Update Date
17 February 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6122238898
Graduation Year
2000 (26 years ago)
PAC ID
7315382504
Group Practice PAC ID
0941648463
Professional Enrollment ID
I20240227003970
Address ID
MN554463813PL4100XNXXX403
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience63
Completeness75
Years active:17State licenses:1Digital endpointsOther names

1,813 MENTAL HEALTH COUNSELOR in MN

Provider Addresses for MAX RICHARD STOLTENBERG (MC, LPCC)

  • 5700 BOTTINEAU BLVD STE 210

    CRYSTAL, MN 554293184

    Phone: (763) 330-2774

    Fax: (763) 330-2775

    Type: Location

  • East Shea Boulevard, Scottsdale, Maricopa County, Arizona, 85259, United States

    SCOTTSDALE, AZ 852544687

    Phone: (602) 499-0378

    Fax: (480) 607-5074

    Type: Mailing

  • 1900 SILVER LAKE RD NW

    NEW BRIGHTON, MN 551121786

    Phone: (651) 628-9566

    Fax: (651) 628-0411

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-02-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240227003970IMental Health CounselorMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55429)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0941648463View full group profile
NameSpecialtyState
Clinical Social WorkerMI
P S Y C H I A T R YMI
Clinical Social WorkerMI
Clinical Social WorkerIN
Clinical Social WorkerMI
P S Y C H I A T R YMI
Clinical Social WorkerMI
Mental Health CounselorOR
Clinical PsychologistOR
Marriage And Family TherapistWA

Reviews

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Frequently asked questions

What is MAX RICHARD STOLTENBERG (MC, LPCC)'s NPI number?
MAX RICHARD STOLTENBERG (MC, LPCC)'s NPI is 1184870610 — the number used across U.S. healthcare to identify this provider.
Is there an active status for MAX RICHARD STOLTENBERG (MC, LPCC)?
For scheduling context, MAX RICHARD STOLTENBERG (MC, LPCC) is shown as active in the registry.
What clinical focus is listed for MAX RICHARD STOLTENBERG (MC, LPCC)?
At a glance, MAX RICHARD STOLTENBERG (MC, LPCC) is tied to Counselor. Clinical services aligned with this taxonomy classification.
What practice footprint exists for MAX RICHARD STOLTENBERG (MC, LPCC)?
Travel planning: use Crystal, Minnesota as the reference point for MAX RICHARD STOLTENBERG (MC, LPCC), then confirm.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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