Heidi Kirsten Bruder

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

28455 Issued in MN

Practice address

156 30TH St NE
Bemidji, MN 56601-5660

Phone

(480) 431-1589

NPI assigned

Mar 7, 2018

Last updated

Feb 3, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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

• Moving Mountains LLC

  • Mental Health Counselor
  • Bemidji, MN
  • NPI 1174296438
  NPD Authorized official

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

{
    "created_epoch": "1520380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1245732049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 SEED FARM RD",
            "city": "SACATON",
            "state": "AZ",
            "postal_code": "85147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 30TH ST NE",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566015660",
            "telephone_number": "480-431-1589"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "415 Lake Shore Dr NE Apt 104",
            "address_purpose": "LOCATION",
            "city": "Bemidji",
            "state": "MN",
            "postal_code": "566014682",
            "country_code": "US",
            "telephone_number": "480-431-1589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUDER",
        "first_name": "HEIDI",
        "middle_name": "KIRSTEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-07",
        "last_updated": "2022-02-03",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "28455",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AZ",
            "license": "LMSW-11285",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Jean Bromenshenkel
• Cathy Brook, COMMUNITY HEALTH
• Kary Ann Brown, RN, CNP
• Lori Lynn Brown, RN
• Kalee Browne
• Jacia Lynn Andrews Bruns, PHARMD
• Robin Leach Buchanan, APRN
• Daneane Rae Budreau, BS
• Lauren Marie Buie, MSW
• Stephanie A Bumgardner, M.S.W., L.I.C.S.W

• Mental Health Counselor in Bemidji, MN
• Providers in Bemidji, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; 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.