Lonni Marie Brickson
Individual provider Active NPI Occupational Therapist · Superior, WI
NPI 1154486041 · NPPES record last updated Jan 5, 2010
Key facts
- NPI
- 1154486041
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 4358-026 (WI)
- Practice address
- 3500 Tower Ave
Superior, WI 54880-5335 - Phone
- (715) 395-5454
- NPI assigned
- Dec 22, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 1999
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
400 E 3Rd St
Duluth, MN 55805-1951
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260113000208 | MN | Practitioner - Occupational Therapist in Private Practice | 5890271555 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 102403 | MN | MD | Occupational Therapist |
| 4358-026 | WI | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Duluth Clinic, LTD. | Current |
Accepting new patients | |
| The Duluth Clinic LTD | Current |
Accepting new patients |
Locations
400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364
3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 102403 | MN | |
| Occupational Therapist | 225X00000X | 4358-026 | WI | Yes |
Addresses
Primary practice location
3500 Tower Ave
Superior, WI 54880-5335
Mailing address
3500 Tower Ave
Superior, WI 54880-5335
Phone (715) 395-5454
Other names
- Lonnie Marie Bjorlin
Other providers in Superior, WI
- Gwendolyn Marie Brand
- Heather Branham
- Holly L Breeden
- Barbara Ann Bremel
- Kaitlyn Brenner
- Bridgeport Counseling
- Brightwater Health Dba Human Development Center
- Brightwater Health Dba Human Development Center
- Toni Louise Britton
- Jan Michael Broad
All providers in Superior, WI · Occupational Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 5, 2010. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.