Individual provider Active NPI

Erica Warffuel

  • Mental Health Counselor
  • Saint Paul, MN
National Provider Identifier
1053913053
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CC03391 Issued in MN
Practice address
1595 Hague Ave
Saint Paul, MN 55104-6233
Phone
(715) 828-5991
NPI assigned
Nov 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CC03391 MN Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X CC305558 MN

Addresses

Primary practice location

1595 Hague Ave
Saint Paul, MN 55104-6233

Mailing address

1595 Hague Ave
Saint Paul, MN 55104-6233
Phone (715) 828-5991

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240918000845 MN Practitioner - Mental Health Counselor 0446791453 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CC305558MNMDAddiction (Substance Use Disorder) Counselor
CC03391MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lyn-Lake Psychotherapy and Wellness LTD. Mental Health CurrentSince Mar 24, 2025 Accepting new patients
Stacia Hanson Ma LP LLC CurrentSince Aug 1, 2024 Accepting new patients

Locations

7101 York Ave S
Ste 317
Minneapolis, MN 55435
Phone (763) 703-4207

2900 Thomas Ave S
Ste 100
Minneapolis, MN 55416

621 W Lake St
Ste 350
Minneapolis, MN 55408
Phone (612) 547-9990

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1605225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1053913053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1595 HAGUE AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046233",
            "telephone_number": "715-828-5991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1595 HAGUE AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046233",
            "telephone_number": "715-828-5991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARFFUEL",
        "first_name": "ERICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-13",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC03391",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "CC305558",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.