Individual provider Active NPI

Cristin Marie Trejos, LICSW, LADC

  • Clinical Social Worker
  • Walker, MN
National Provider Identifier
1225420615
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
30979 Issued in MN
Practice address
4621 State 200 NW
Walker, MN 56484-2619
Phone
(218) 252-4753
NPI assigned
Feb 23, 2015
Last updated
Mar 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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 303931 MN
Clinical Social Worker 1041C0700X 30979 MN Primary

Addresses

Primary practice location

4621 State 200 NW
Walker, MN 56484-2619

Mailing address

PO Box 1424
Walker, MN 56484-1424
Phone (218) 252-4753

Other names 1

  • Cristin Marie Evans Former name

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
I20241120001442 MN Practitioner - Clinical Social Worker 4789119355 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
303931MNMDAddiction (Substance Use Disorder) Counselor
30979MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Enlightenment Psychiatry LLC CurrentSince Oct 29, 2024 Accepting new patients

Locations

1011 1st St E
Ste 5
Park Rapids, MN 56470
Phone (320) 321-9599

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1424649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1225420615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1424",
            "city": "WALKER",
            "state": "MN",
            "postal_code": "564841424",
            "telephone_number": "218-252-4753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4621 STATE 200 NW",
            "city": "WALKER",
            "state": "MN",
            "postal_code": "564842619",
            "telephone_number": "218-252-4753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREJOS",
        "first_name": "CRISTIN",
        "middle_name": "MARIE",
        "credential": "LICSW, LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-23",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303931",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "30979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRISTIN",
            "last_name": "EVANS",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Walker, MN

Sources for this page

Verify at the official NPI Registry.