Active NPI
Ross Lustig, LPCC
- Professional Counselor
- Owatonna, MN
National Provider Identifier
1194190819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPCC 1114
- Practice address
- 610 Florence Ave
Owatonna, MN 55060-4704 - Phone
- (507) 455-8118
- Fax
- (507) 455-8133
- NPI assigned
- Dec 7, 2015
- Sex
- Male
- Sole proprietor
- No
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 | LPCC 1114 | MN | Primary |
Addresses
Primary practice location
610 Florence Ave
Owatonna, MN 55060-4704
Mailing address
610 Florence Ave
Owatonna, MN 55060-4704
Phone (507) 455-8118
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | messagec@direct.schrc.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPCC 1114 | MN | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612915200000",
"number": "1194190819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 FLORENCE AVE",
"city": "OWATONNA",
"state": "MN",
"postal_code": "550604704",
"telephone_number": "507-455-8118",
"fax_number": "507-455-8133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 FLORENCE AVE",
"city": "OWATONNA",
"state": "MN",
"postal_code": "550604704",
"telephone_number": "507-455-8118",
"fax_number": "507-455-8133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUSTIG",
"first_name": "ROSS",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-12-07",
"last_updated": "2021-02-10",
"certification_date": "2021-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MN",
"license": "LPCC 1114",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "messagec@direct.schrc.com",
"affiliation": "N",
"address_1": "610 Florence Ave",
"city": "Owatonna",
"state": "MN",
"country_code": "US",
"postal_code": "550604704",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.