Individual provider Active NPI

Anna Noel Rydberg

  • Mental Health Counselor
  • Pine City, MN
National Provider Identifier
1306609201
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4252 Issued in MN
Practice address
705 Hillside Ave SW
Pine City, MN 55063-1466
Phone
(320) 629-7600
NPI assigned
Feb 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 4252 MN Primary

Addresses

Primary practice location

705 Hillside Ave SW
Pine City, MN 55063-1466

Mailing address

400 Airport Rd NE
Pine City, MN 55063-1454
Phone (320) 280-0836

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
I20240219000488 MN Practitioner - Mental Health Counselor 7618311622 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeutic Services Agency Inc CurrentSince Feb 5, 2024 Accepting new patients

Locations

705 Hillside Ave SW
Pine City, MN 55063

220 Railroad St SE
Pine City, MN 55063

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1306609201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 AIRPORT RD NE",
            "city": "PINE CITY",
            "state": "MN",
            "postal_code": "550631454",
            "telephone_number": "320-280-0836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 HILLSIDE AVE SW",
            "city": "PINE CITY",
            "state": "MN",
            "postal_code": "550631466",
            "telephone_number": "320-629-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDBERG",
        "first_name": "ANNA",
        "middle_name": "NOEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "4252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine City, MN

Sources for this page

Verify at the official NPI Registry.