Angela Ann Ackerman, MA, LPCC
Individual provider Active NPI Professional Counselor · Brooklyn Center, MN
NPI 1093345902 · NPPES record last updated Nov 15, 2023
Key facts
- NPI
- 1093345902
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 2351 (MN)
- Practice address
- 6040 Earle Brown Dr
Brooklyn Center, MN 55430-2514 - Phone
- (651) 313-8080
- NPI assigned
- Jan 20, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2351 | MN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nystrom & Associates, LTD | Current |
Accepting new patients | |
| Secure Base Counseling Center LLC | Past |
Accepting new patients |
Locations
1370 Mendota Heights Rd
Mendota Heights, MN 55120
Phone (651) 583-4447
6040 Earle Brown Dr
Ste 100
Minneapolis, MN 55430
Phone (612) 470-4576
1150 Montreal Ave
Ste 107
Saint Paul, MN 55116
Phone (651) 303-8080
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2351 | MN | Yes |
Addresses
Primary practice location
6040 Earle Brown Dr
Brooklyn Center, MN 55430-2514
Mailing address
1370 Mendota Heights Rd
Mendota Heights, MN 55120-1281
Phone (651) 313-8080
Other names
- Angela Rauchwarter
Other providers in Brooklyn Center, MN
- Ablecare Services LLC
- Florence Atieno Aboge
- Abundant Life Home Health Care
- Acacia Care LLC
- Accessible Home Health Care, LLC
- Active Transportation Services LLC
- Alyssa Adams
- Catherine Adamson
- Faduma Adem
- Advanced Behavioral Health, Inc
All providers in Brooklyn Center, MN · Professional Counselor in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 15, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.