Individual provider Active NPI

Jonathan Berntson

  • Professional Counselor
  • Moorhead, MN
National Provider Identifier
1295266831
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CC01483 Issued in MN
Practice address
1547 30TH Ave S
Moorhead, MN 56560-5149
Phone
(218) 287-4338
Fax
(218) 287-5928
NPI assigned
Mar 24, 2017
Last updated
Oct 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X CC01483 MN Primary

Addresses

Primary practice location

1547 30TH Ave S
Moorhead, MN 56560-5149

Mailing address

1547 30TH Ave S
Moorhead, MN 56560-5149
Phone (218) 287-4338

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
I20231228001410 MN Practitioner - Mental Health Counselor 1759731094 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CC01483MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Solutions Behavioral Healthcare Professionals, PC CurrentSince Jan 1, 2024 Accepting new patients

Locations

1547 30th Ave S
Moorhead, MN 56560
Phone 21828743381113

891 Belsly Blvd
Moorhead, MN 56560
Phone (701) 412-2973

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": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1295266831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1547 30TH AVE S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565605149",
            "telephone_number": "218-287-4338",
            "fax_number": "218-287-5928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1547 30TH AVE S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565605149",
            "telephone_number": "218-287-4338",
            "fax_number": "218-287-5928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNTSON",
        "first_name": "JONATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-24",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC01483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorhead, MN

Sources for this page

Verify at the official NPI Registry.