NPIMap

Organization Active NPI

Two Rivers Counseling LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Duluth, MN
National Provider Identifier
1093486722
Registry record updated Feb 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
TWO RIVERS COUNSELING LLC
Practice address
404 W Superior St Ste 210
Duluth, MN 55802-1569
Phone
(218) 606-1100
Fax
(218) 520-1799
NPI assigned
Sep 22, 2021
Last updated
Feb 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2023

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

Authorized official

Name
Eve-Lynn R Fellersen, LPCCNPI 1740744853
Title
Owner
Phone
(218) 606-1100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

404 W Superior St Ste 210
Duluth, MN 55802-1569

Mailing address

404 W Superior St Ste 210
Duluth, MN 55802-1569
Phone (218) 606-1100

Other practice location 1

227 7th St
Two Harbors, MN 55616-1530
Phone (218) 606-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230407001195 MN Part B Supplier - Clinic/Group Practice 7416322268 Receives reassigned benefits from 18 practitioners
Practice locations: Duluth, MN; Two Harbors, MN

National Provider Directory

National Provider Directory

Locations

222 W Superior St
Ste 200
Duluth, MN 55802
Phone (218) 606-1100

324 W Superior St
Ste 502
Duluth, MN 55802

404 W Superior St
Ste 210
Duluth, MN 55802
Phone (218) 302-4866

227 7th St
Two Harbors, MN 55616
Phone (218) 428-4956

418 7th St
Two Harbors, MN 55616
Phone (218) 606-1100

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1632268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675468800000",
    "number": "1093486722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 W SUPERIOR ST STE 210",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021569",
            "telephone_number": "218-606-1100",
            "fax_number": "218-520-1799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 W SUPERIOR ST STE 210",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021569",
            "telephone_number": "218-606-1100",
            "fax_number": "218-520-1799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "227 7th St",
            "address_purpose": "LOCATION",
            "city": "Two Harbors",
            "state": "MN",
            "postal_code": "556161530",
            "country_code": "US",
            "telephone_number": "218-606-1100",
            "fax_number": "218-520-1799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TWO RIVERS COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-22",
        "last_updated": "2023-02-04",
        "certification_date": "2023-02-04",
        "status": "A",
        "authorized_official_last_name": "FELLERSEN",
        "authorized_official_first_name": "EVE-LYNN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-606-1100",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.