Eastwest Counseling and Consulting PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

EASTWEST COUNSELING AND CONSULTING PLLC

Practice address

18510 MN-371
Suite a
Brainerd, MN 56401

Phone

(218) 537-8680

NPI assigned

Dec 21, 2023

Organization subpart

No

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

Authorized official

Name

Casey Wagner, MSW, LICSWNPI 1740777838

Title

Therapist

Phone

(218) 537-8680

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Casey Wagner, LICSW

  • Clinical Social Worker
  • Brainerd, MN
  • NPI 1740777838
  Medicare reassignment Care Compare group NPD Authorized official
• Lily S Wagner, MSW, LICSW

  • Clinical Social Worker
  • Baxter, MN
  • NPI 1366172066
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1703116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705622400000",
    "number": "1164291902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18510 MN-371",
            "address_2": "SUITE A",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "56401",
            "telephone_number": "218-537-8680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18510 MN-371",
            "address_2": "SUITE A",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "56401",
            "telephone_number": "218-537-8680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTWEST COUNSELING AND CONSULTING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-21",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "CASEY",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "218-537-8680",
        "authorized_official_credential": "MSW, LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Dunphy
• Tyler John Dunphy, MD
• Rylea Ellizabeth Durbin
• Kimberly M Dylla, CRNA
• Stephanie Eastman, RN
• Easy Hearing Clinic LLC
• Shae Edgerton
• Edgewood Brainerd Senior Living LLC
• Deanne Ehlert
• Christa A Eickhoff, M.D.

• Clinical Social Worker in Brainerd, MN
• Providers in Brainerd, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; 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.