MR. PAUL LUKE MLADNICK (LMFT) – Marriage & Family Therapist, NPI 1487843355

MR. PAUL LUKE MLADNICK (LMFT) is a healthcare provider. based in Forest lake, Minnesota. specializing in MARRIAGE AND FAMILY THERAPIST. They hold the professional credentials LMFT. They hold a License No. 1306 (MN). The NPI Number for MR. PAUL LUKE MLADNICK (LMFT) is 1487843355

Main info

Male
Sole Proprietor
44 Years Of Experience
Name
MR. PAUL LUKE MLADNICK (LMFT)
NPI
1487843355
Phone
(612) 719-7966
Address
1068 SO LAKE ST
Enumeration Date
17 October 2007
Last Update Date
17 October 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6519824792
Graduation Year
1982 (44 years ago)
PAC ID
3577901321
Professional Enrollment ID
I20240329001598
Address ID
MN550252633FO1068XSXXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

981 MARRIAGE AND FAMILY THERAPIST in MN

Provider Addresses for MR. PAUL LUKE MLADNICK (LMFT)

  • 1068 SO LAKE ST

    #109

    FOREST LAKE, MN 55025

    Phone: (612) 719-7966

    Fax: (651) 982-6035

    Mailing address matches the actual address.

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: 2024-03-29

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
I20240329001598IMarriage And Family TherapistMNTBD

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

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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 55025)

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Reviews

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Frequently asked questions

Is MR. PAUL LUKE MLADNICK (LMFT) listed with a National Provider Identifier?
Yes — MR. PAUL LUKE MLADNICK (LMFT) has NPI 1487843355 on file in the registry.
Is there an active status for MR. PAUL LUKE MLADNICK (LMFT)?
For scheduling context, MR. PAUL LUKE MLADNICK (LMFT) is shown as active in the registry.
What area of care is associated with MR. PAUL LUKE MLADNICK (LMFT)?
MR. PAUL LUKE MLADNICK (LMFT)'s record emphasizes Marriage & Family Therapist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for MR. PAUL LUKE MLADNICK (LMFT)?
Travel planning: use Forest Lake, Minnesota as the reference point for MR. PAUL LUKE MLADNICK (LMFT), then confirm.
When was this NPI issued?
Enumeration for MR. PAUL LUKE MLADNICK (LMFT) is noted as October 17, 2007 where the registry provides it.

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