Rebecca Jane Ellmann, MA, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC02183 Issued in MN

Practice address

6636 Cedar Ave S
Richfield, MN 55423-2705

Phone

(612) 512-1085

Fax

(612) 268-5858

NPI assigned

Aug 19, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Affinity Psychological Services, P.C.

  • Mental Health Counselor
  • Edina, MN
  • NPI 1245610856
  Medicare reassignment NPD
• Fraser

  • Rehabilitation Clinic/Center
  • Richfield, MN
  • NPI 1063568574
  NPD (past)
• Fraser Child and Family Center

  • Adolescent and Children Mental Health Clinic/Center
  • Minneapolis, MN
  • NPI 1609922194
  NPD (past)

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

{
    "created_epoch": "1566172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1073160776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6636 CEDAR AVE S",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232705",
            "telephone_number": "612-512-1085",
            "fax_number": "612-268-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6636 CEDAR AVE S",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232705",
            "telephone_number": "612-512-1085",
            "fax_number": "612-268-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLMANN",
        "first_name": "REBECCA",
        "middle_name": "JANE",
        "credential": "MA, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-19",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC02183",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC02183",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald Charles Ehlers, DDS
• Katherine Marie Eiden, OTR/L
• Brian T Eipperle, PT
• Elizabeth McPeek LLC
• Katherine J Ellefson, RD,CD
• Emerald Therapy LLC
• Encouraging Life Resources
• Enjoy the Journey Counseling
• Jessica Enneking, LMFT
• Yvette Erasmus, PSY.D.

• Mental Health Counselor in Richfield, MN
• Providers in Richfield, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.