Michael Paul Rydberg, LICSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6486 Issued in MN

Practice address

911 18TH St N
Saint Cloud, MN 56303-1203

Phone

(320) 650-1650

Fax

(320) 650-1528

NPI assigned

Dec 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Nov 27, 2023 through Nov 27, 2027

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Center for Family Counseling Inc

  • Adult Mental Health Clinic/Center
  • Saint Cloud, MN
  • NPI 1588731327
  NPD (past)

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366505869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2390",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563022390",
            "telephone_number": "320-650-1550",
            "fax_number": "320-650-1528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 18TH ST N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031203",
            "telephone_number": "320-650-1650",
            "fax_number": "320-650-1528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDBERG",
        "first_name": "MICHAEL",
        "middle_name": "PAUL",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "6486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Rushmeyer
• Ashley Ruter
• Alison Rutten, RPH
• Breana Ruud, BCBA
• Elizabeth Ryan
• Richard L Rysavy, M.D.
• Timothy Ryan Rysavy, PSYD, LP
• Carolyn Dee Rysgaard, MD
• Kimberly Marie Rzeszutko, DPT
• S.B. Consulting L.L.C.

• Social Worker in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.