Organization Active NPI

Indigo Counseling PLC

  • Adult Mental Health Clinic/Center
  • Brainerd, MN
National Provider Identifier
1093542862
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
INDIGO COUNSELING PLC
Practice address
624 NW 5TH St
Brainerd, MN 56401-2904
Phone
(218) 232-3089
Fax
(218) 302-0440
NPI assigned
Sep 16, 2024
Last updated
Mar 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Authorized official

Name
Karla Van Wienen
Title
Credentialing / Contracting
Phone
(320) 746-0025

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU

Addresses

Primary practice location

624 NW 5TH St
Brainerd, MN 56401-2904

Mailing address

6736 Ojibwa Rd
Brainerd, MN 56401-7034
Phone (218) 232-3089

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241105000372 MN Part B Supplier - Clinic/Group Practice 0345773933 Receives reassigned benefits from 1 practitioner
Practice locations: Brainerd, MN

National Provider Directory

National Provider Directory

Locations

315 E River Rd
Ste 205
Brainerd, MN 56401
Phone (218) 270-9525

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773100800000",
    "number": "1093542862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6736 OJIBWA RD",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564017034",
            "telephone_number": "218-232-3089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 NW 5TH ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564012904",
            "telephone_number": "218-232-3089",
            "fax_number": "218-302-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIGO COUNSELING PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-16",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A",
        "authorized_official_last_name": "VAN WIENEN",
        "authorized_official_first_name": "KARLA",
        "authorized_official_title_or_position": "CREDENTIALING / CONTRACTING",
        "authorized_official_telephone_number": "320-746-0025"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brainerd, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2026; 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.