Emy Lou Carlson, MS, NCC, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2790 Issued in MN

Practice address

1300 Anne St NW
Bemidji, MN 56601-5103

Phone

(218) 333-5000

NPI assigned

Nov 20, 2017

Last updated

Aug 13, 2024By the provider in NPPES

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, SD2 enrollments

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 2

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sanford Health of Northern MinnesotaGroup PAC ID 5597725168, shared by 21 NPIs, 349 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sanford Health of Northern Minnesota

  dba Sanford Health Kelliher Clinic

  • Family Medicine Physician
  • Kelliher, MN
  • NPI 1770849697
  Medicare reassignment NPD
• Sanford Health of Northern Minnesota

  dba Joe Lueken Cancer Center

  • Internal Medicine Physician
  • Bemidji, MN
  • NPI 1780628149

  SD

  Medicare reassignment NPD
• Ortonville Area Health Services

  • Family Medicine Physician
  • Ortonville, MN
  • NPI 1033785449
  NPD
• Ortonville Area Health Services

  • Critical Access Hospital Clinic/Center
  • Ortonville, MN
  • NPI 1477799765
  NPD

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

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1134633670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 ANNE ST NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566015103",
            "telephone_number": "218-333-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 S Maple Ste 209",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "SD",
            "postal_code": "572013772",
            "country_code": "US",
            "telephone_number": "605-868-6269",
            "fax_number": "605-868-6269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "EMY",
        "middle_name": "LOU",
        "credential": "MS, NCC, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-20",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SD",
            "license": "LPC20233",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "2790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy Lynn Cameron, OTR
• Allan Campbell, M.D.
• Chase Campbell
• William Lynn Canada, D.D.S.
• Kortney Carlin, MS, LADC
• Mark Joel Carlson, M.D.
• Jason Joseph Caron, MD
• James R Carpenter, MD
• Jennifer Carter Berg, PSYD
• Jessica Carter, RD

• Professional Counselor in Bemidji, MN
• Providers in Bemidji, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.