Brenda J Arnold, MS,NCC,LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC00577 Issued in MN

Practice address

6331 Hidden LN
South Haven, MN 55382-4555

Phone

(320) 492-7939

NPI assigned

Jun 27, 2013

Last updated

Jun 27, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rejuv Medical PAGroup PAC ID 2264598077, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/32275/brand/1/csg/1/fhir/r4

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.

• Rejuv Medical, P.a.

  • Medical Specialty Clinic/Center
  • Waite Park, MN
  • NPI 1033355086
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1372291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372291200000",
    "number": "1174963748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6331 HIDDEN LN",
            "city": "SOUTH HAVEN",
            "state": "MN",
            "postal_code": "553824555",
            "telephone_number": "320-492-7939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6331 HIDDEN LN",
            "city": "SOUTH HAVEN",
            "state": "MN",
            "postal_code": "553824555",
            "telephone_number": "320-492-7939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNOLD",
        "first_name": "BRENDA",
        "middle_name": "J",
        "credential": "MS,NCC,LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-27",
        "last_updated": "2013-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC00577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Blasczyk
• Sarah Louise Demarais, PTA
• Finesse Carpentry LLC
• Lynette Carol Imdieke-Struzyk, MS, LPCC
• Janell Dawn Missler

• Professional Counselor in South Haven, MN
• Providers in South Haven, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2013; 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.