Angela Rose Ackerman, LPCC
Individual provider Active NPI Professional Counselor · St. Cloud, MN
NPI 1235644386 · NPPES record last updated Feb 2, 2026
Key facts
- NPI
- 1235644386
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- CC0166 (MN)
- Practice address
- 3400 1St Street N, Suite 101
St. Cloud, MN 56303 - Phone
- (612) 268-5858
- NPI assigned
- Dec 12, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240411002259 | MN | Practitioner - Mental Health Counselor | 1850730763 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CC0166 | MN | MD | Professional Counselor |
| 1666 | MN | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Affinity Psychological Services, P.C. | Mental Health | Current |
Accepting new patients |
| Greater Minnesota Family Services | Mental Health | Past |
Accepting new patients |
| Imagine Perspectives | Past |
Accepting new patients |
Locations
7401 Metro Blvd
Ste 250
Minneapolis, MN 55439
Phone (612) 778-8393
7401 Metro Blvd
Ste 525
Minneapolis, MN 55439
3400 1st St N
Ste 101
Saint Cloud, MN 56303
Phone (320) 202-2000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Professional Counselor | 101YP2500X | CC0166 | MN | Yes |
Addresses
Primary practice location
3400 1St Street N, Suite 101
St. Cloud, MN 56303
Mailing address
1001 Kingwood St Ste 127
Brainerd, MN 56401-3452
Phone (218) 203-0307
Other practice location 1
1001 Kingwood St Ste 127
Brainerd, MN 56401-3452
Phone (218) 203-0307
Other practice location 2
7401 Metro Blvd., Suite 250
Edina, MN 55439
Phone (612) 268-5858
Other providers in St. Cloud, MN
- Acceleratre Chiropractic & Rehab
- Access Homehealth LLC
- Access Transportation Services Inc
- Accurate Hearing Services Inc
- Achieved Goals, LLC
- Cassandra Lee Ackerman
- Joshua Robert Ackerman
- Kelly Elaine Ackerman
- Acquire Health Center LLC
- Angela Adamek
All providers in St. Cloud, MN · Professional Counselor in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.