Emily Coler Hanson, M.S., LMFT, CGP
Individual provider Active NPI Marriage & Family Therapist · Jamestown, ND
NPI 1255657409 · NPPES record last updated Mar 9, 2018
Key facts
- NPI
- 1255657409
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 2012-040 (ND)
- Practice address
- Anne Carlsen Center
701 3Rd St NW
Jamestown, ND 58401-8000 - Phone
- (218) 443-2837
- NPI assigned
- Apr 13, 2010
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
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 |
|---|---|---|---|---|
| I20240131000825 | MN | Practitioner - Marriage and Family Therapist | 3476906074 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2012-040 | ND | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nystrom & Associates, LTD | Marriage & Family Therapist | Current |
Accepting new patients |
Locations
4150 Olson Memorial Hwy
Ste 110
Golden Valley, MN 55422
Phone (763) 301-9998
1370 Mendota Heights Rd
Mendota Heights, MN 55120
Phone (651) 583-4447
1150 Montreal Ave
Ste 107
Saint Paul, MN 55116
Phone (651) 303-8080
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 2012-040 | ND | Yes |
Addresses
Primary practice location
Anne Carlsen Center
701 3Rd St NW
Jamestown, ND 58401-8000
Mailing address
Anne Carlsen Center
701 3Rd St NW
Jamestown, ND 58401-8000
Phone (218) 443-2837
Other providers in Jamestown, ND
- David L Clinkenbeard
- Clinton S. Miller P.C.
- Jordon Colbert
- Jeannine Kathleen Colburn
- Jessica Rose Colburn
- John D Collins
- Community MRI Services, LLC
- Lincoln D. Coombs
- Gary Cornforth
- Cora Courage
All providers in Jamestown, ND · Marriage & Family Therapist in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2018. 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.