Amy Jo Anderly-Dotson, L.A.D.C., L.I.C.S.W

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

18704 Issued in MN

Practice address

190 Sailstar Dr NW
Cass Lake, MN 56633

Phone

(218) 335-3050

Fax

(218) 335-4410

NPI assigned

Nov 30, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  NPD (past)

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1215119367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 SAILSTAR DR NW",
            "city": "CASS LAKE",
            "state": "MN",
            "postal_code": "56633",
            "telephone_number": "218-335-3050",
            "fax_number": "218-335-4410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 SAILSTAR DR NW",
            "city": "CASS LAKE",
            "state": "MN",
            "postal_code": "56633",
            "telephone_number": "218-335-3050",
            "fax_number": "218-335-4410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "403 4th St NW",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Bemidji",
            "state": "MN",
            "postal_code": "566013142",
            "country_code": "US",
            "telephone_number": "218-444-5155",
            "fax_number": "218-333-3291",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Nystrom Associates Limited",
            "address_2": "112 1st Street West",
            "address_purpose": "LOCATION",
            "city": "Bemidji",
            "state": "MN",
            "postal_code": "56601",
            "country_code": "US",
            "telephone_number": "218-888-8032",
            "fax_number": "218-888-8033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERLY-DOTSON",
        "first_name": "AMY",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "L.A.D.C., L.I.C.S.W",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-30",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "302225",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "18704",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "18704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sameena Ahmed-Buehler, MD
• Brittany S Anderson
• Christine Ann Anderson, MT
• Stefani Sue Anderson, RN
• Dana P Baumgartner, RN
• Henry Louis Beauduy, MSW, LICSW

• All providers in Cass Lake, MN
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.