Individual provider Active NPI

Tristen Roerick, MS, LMFT

  • Marriage & Family Therapist
  • Sartell, MN
National Provider Identifier
1376488452
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4569 Issued in MN
Practice address
110 14TH Ave E
Sartell, MN 56377-4644
Phone
(320) 202-1400
Fax
(320) 202-8662
NPI assigned
Apr 23, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 4569 MN Primary

Addresses

Primary practice location

110 14TH Ave E
Sartell, MN 56377-4644

Mailing address

30684 County Road 41
Albany, MN 56307-9417
Phone (320) 202-1400

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
I20260603001427 MN Practitioner - Marriage and Family Therapist 2466923230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

110 14TH Ave E
Sartell, MN 56377-4644

617 Oak St
Brainerd, MN 56401-3610

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4569MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Core Professional Services, P.a. CurrentSince Mar 28, 2026 Accepting new patients

Locations

110 14th Ave E
Sartell, MN 56377
Phone (320) 202-1400

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": "1776902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1376488452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30684 COUNTY ROAD 41",
            "city": "ALBANY",
            "state": "MN",
            "postal_code": "563079417",
            "telephone_number": "320-202-1400",
            "fax_number": "320-202-8662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 14TH AVE E",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563774644",
            "telephone_number": "320-202-1400",
            "fax_number": "320-202-8662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROERICK",
        "first_name": "TRISTEN",
        "credential": "MS, LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-04-23",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "4569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sartell, MN

Sources for this page

Verify at the official NPI Registry.