Brian Arthur Nystrom, L.I.C.S.W., L.M.F.T.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

06197 Issued in MN

Practice address

Brighton Professional BLDG
1900 Silver Lake Road #110
New Brighton, MN 55112-1789

Phone

(651) 628-9566

Fax

(651) 628-0411

NPI assigned

Jun 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  Medicare reassignment NPD
• Nystrom & Associates, LTD

  • Mental Health Counselor
  • New Brighton, MN
  • NPI 1790872562
  NPD (past)
• Nystrom & Associates, LTD.

  • Adult Mental Health Clinic/Center
  • New Brighton, MN
  • NPI 1467761742
  NPD (past)
• Nystrom & Associates, LTD.

  • Addiction (Substance Use Disorder) Counselor
  • New Brighton, MN
  • NPI 1902934565
  NPD (past)

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211846400000",
    "number": "1326075813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BRIGHTON PROFESSIONAL BLDG",
            "address_2": "1900 SILVER LAKE ROAD #110",
            "city": "NEW BRIGHTON",
            "state": "NE",
            "postal_code": "551121789",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BRIGHTON PROFESSIONAL BLDG",
            "address_2": "1900 SILVER LAKE ROAD #110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121789",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYSTROM",
        "first_name": "BRIAN",
        "middle_name": "ARTHUR",
        "credential": "L.I.C.S.W., L.M.F.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2008-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "06197",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "0145",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001857100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nystrom & Associates, LTD
• Nystrom & Associates, LTD
• Nystrom & Associates, LTD
• Nystrom & Associates, LTD.
• Nystrom & Associates, LTD.
• O'Wow Home Care Services LLC
• Oak Ridg Chiropractic LTD
• Jesse Alexander Ochoa, PA-C
• Ifeoma Odor, LICSW
• Odyssey Programs, LLC

• Clinical Social Worker in New Brighton, MN
• Providers in New Brighton, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.