COACH NAKUMBE (LPCC, LADC) – Mental Health Counselor, NPI 1225570740

COACH NAKUMBE (LPCC, LADC) is a healthcare provider. based in Edina, Minnesota. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LPCC, LADC. They hold a License No. 303344 (MN). The NPI Number for COACH NAKUMBE (LPCC, LADC) is 1225570740

Main info

Male
Sole Proprietor
6 Years Of Experience
Name
COACH NAKUMBE (LPCC, LADC)
NPI
1225570740
Phone
(612) 284-2151
Address
4940 W 77th St
Enumeration Date
15 November 2016
Last Update Date
30 November 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6122685858
Graduation Year
2020 (6 years ago)
PAC ID
5193167351
Group Practice PAC ID
0749528552
Professional Enrollment ID
I20240521000294
Address ID
MN554251139BL1550XEXXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:9State licenses:2Digital endpointsOther names

1,813 MENTAL HEALTH COUNSELOR in MN

Provider Addresses for COACH NAKUMBE (LPCC, LADC)

  • 4940 W 77th St

    Edina, MN 554354805

    Phone: (612) 284-2151

    Type: Location

  • Earle Brown Drive, Brooklyn Center, Hennepin County, Minnesota, 55430, United States

    BROOKLYN CENTER, MN 554309902

    Phone: (612) 865-1725

    Type: Location

  • 8014 HIGHWAY 55 APT 197

    GOLDEN VALLEY, MN 554274712

    Phone: (612) 234-1044

    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: 2024-05-21

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
I20240521000294IMental 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 55435)

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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: 0749528552View full group profile
NameSpecialtyState
Mental Health CounselorMN
Mental Health CounselorMN
Clinical PsychologistMN
Mental Health CounselorMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Marriage And Family TherapistMN
Mental Health CounselorMN
Marriage And Family TherapistMN
Marriage And Family TherapistMN

Reviews

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Frequently asked questions

Is COACH NAKUMBE (LPCC, LADC) listed with a National Provider Identifier?
Yes — COACH NAKUMBE (LPCC, LADC) has NPI 1225570740 on file in the registry.
Is COACH NAKUMBE (LPCC, LADC) still an active registrant?
COACH NAKUMBE (LPCC, LADC) carries an active NPI according to the public dataset.
How would a patient describe COACH NAKUMBE (LPCC, LADC)'s focus?
For COACH NAKUMBE (LPCC, LADC), the primary taxonomy reads as Mental Health Counselor. Clinical services aligned with this taxonomy classification.
What practice footprint exists for COACH NAKUMBE (LPCC, LADC)?
Travel planning: use Edina, Minnesota as the reference point for COACH NAKUMBE (LPCC, LADC), then confirm.
When was this NPI issued?
Enumeration for COACH NAKUMBE (LPCC, LADC) is noted as November 15, 2016 where the registry provides it.

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