Active NPI
Randa Ericson
- Professional Counselor
- Brainerd, MN
National Provider Identifier
1164238697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4731
- Practice address
- 2424 Business 371
Brainerd, MN 56401-8306 - Phone
- (218) 833-8799
- NPI assigned
- Dec 9, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4731 | MN | Primary |
Addresses
Primary practice location
2424 Business 371
Brainerd, MN 56401-8306
Mailing address
2424 Business 371
Brainerd, MN 56401-8306
Phone (218) 833-8799
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2365 Ariel St N
Maplewood, MN 55109-2248
Phone (612) 373-3366
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Minnesota Teen Challenge, Inc | Current | Accepting new patients | |
| Minnesota Teen Challenge, Inc | Past | Accepting new patients |
Locations
2756 Douglas Dr N
Minneapolis, MN 55422
Phone (763) 544-9126
740 E 24th St
Minneapolis, MN 55404
Phone (612) 238-6238
2365 Ariel St N
Saint Paul, MN 55109
Phone (612) 777-8987
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Minneapolis, MN
- NPI 1831574797
-
- Substance Abuse Rehabilitation Facility
- Brainerd, MN
- NPI 1528360591
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733702400000",
"number": "1164238697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2424 BUSINESS 371",
"city": "BRAINERD",
"state": "MN",
"postal_code": "564018306",
"telephone_number": "218-833-8799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2424 BUSINESS 371",
"city": "BRAINERD",
"state": "MN",
"postal_code": "564018306",
"telephone_number": "218-833-8799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERICSON",
"first_name": "RANDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-12-09",
"last_updated": "2024-12-09",
"certification_date": "2024-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MN",
"license": "4731",
"primary": true
}
],
"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 Dec 9, 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.