Angie Marie Williamson, MS, LPCC, RDN, LDN
Individual provider Active NPI Professional Counselor · Osakis, MN
NPI 1124315064 · NPPES record last updated Oct 8, 2024
Key facts
- NPI
- 1124315064
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- CC02695 (MN)
- Practice address
- 610 W 1St Ave
Osakis, MN 56360-8227 - Phone
- (952) 484-0841
- NPI assigned
- Jun 29, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2024 through Apr 1, 2028
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CC02695 | MN | MD | Professional Counselor |
| 886167 | MN | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central MN Healing Center, PLLC | Current |
Accepting new patients | |
| Solutions Behavioral Healthcare Professionals, PC | Past | Accepting new patients | |
| North Country Counseling P.C. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 886167 | MN | |
| Professional Counselor | 101YP2500X | CC02695 | MN | Yes |
Addresses
Primary practice location
610 W 1St Ave
Osakis, MN 56360-8227
Mailing address
PO Box 120
Osakis, MN 56360-0120
Phone (320) 766-6333
Other providers in Osakis, MN
- Colleen Savageau
- Meghan Amanda Stadsklev
- Terrace Heights Assisted Living Apartments
- Kellie Vannyhuis
- West View Assisted Living Apartments
- Ana Wood
All providers in Osakis, 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 Oct 8, 2024. 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.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.