Individual provider Active NPI

Sabrina Segelstrom, MA, LADC, LPCC

  • Mental Health Counselor
  • Saint Paul, MN
National Provider Identifier
1194338210
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CC02367 Issued in MN
Practice address
1246 University Ave W
Saint Paul, MN 55104-4125
Phone
(651) 314-1137
NPI assigned
Aug 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X CC02367 MN Primary

Addresses

Primary practice location

1246 University Ave W
Saint Paul, MN 55104-4125

Mailing address

1246 University Ave W
Saint Paul, MN 55104-4125

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250225001115 MN Practitioner - Mental Health Counselor 2264952910 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
CC02367MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA Mental Health CurrentSince Feb 13, 2025 Accepting new patients

Locations

729 Washington Ave N
Ste 600
Minneapolis, MN 55401
Phone (334) 463-3099

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1194338210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1246 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1246 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044125",
            "telephone_number": "651-314-1137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGELSTROM",
        "first_name": "SABRINA",
        "credential": "MA, LADC, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-28",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC02367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.