Steffan Immerfall

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4264 Issued in MN

Practice address

927 Trettel LN
Cloquet, MN 55720-1345

Phone

(218) 879-1227

NPI assigned

Mar 25, 2024

Sex

Male

Sole proprietor

Yes

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

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

Interoperability endpoints

• Direct secure messaging: steffan.immerfall.p1@direct.fonddulachsd.nextgenshare.com

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.

• Fond Du Lac Reservation Business Committee

  dba Fond du Lac Human Services Division

  • Clinic/Center
  • Cloquet, MN
  • NPI 1326053166
  Medicare reassignment NPD
• Fond Du Lac Reservation Business Committee

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cloquet, MN
  • NPI 1053772087
  NPD

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1396595302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2516 E 7TH ST",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548803832",
            "telephone_number": "218-349-6434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 TRETTEL LN",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557201345",
            "telephone_number": "218-879-1227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMMERFALL",
        "first_name": "STEFFAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-25",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "4264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Hughes
• Mark D Hunt, MA, LPCC
• Bryan Paul Hunter, APRN, CRNA
• Rebecca Ann Hup, D.D.S.
• Ryan K Hursh, APRN, CNP
• Independent School District 93 Carlton County
• Kijsa Irwin, RN AND CFCN
• Kathleen Ann Jarve, LGSW
• Jacqueline Marie Jennissen, ADC-T
• Margarita York Jesme, DNP, APRN, FNP-C

• Mental Health Counselor in Cloquet, MN
• Providers in Cloquet, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; 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.