Individual provider Active NPI

Erin Michelle Buck, LADC

  • Mental Health Counselor
  • Cottage Grove, MN
National Provider Identifier
1417569765
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3829 Issued in MN
Practice address
8127 113TH Street CT S
Cottage Grove, MN 55016-4511
Phone
(612) 275-2817
NPI assigned
Aug 18, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 305741 MN
Mental Health Counselor 101YM0800X 3829 MN Primary

Addresses

Primary practice location

8127 113TH Street CT S
Cottage Grove, MN 55016-4511

Mailing address

8127 113TH Street CT S
Cottage Grove, MN 55016-4511
Phone (612) 275-2817

Other practice location 1

1619 Dayton Ave Ste 325
Saint Paul, MN 55104-6495
Phone (763) 228-4752

Other practice location 2

2000 White Bear Ave N Unit 2
Maplewood, MN 55109-3713
Phone (612) 767-0300

Other identifiers 1

IdentifierTypeStateIssuer
L352176881710OtherMNDRIVERS LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
305741MNMDAddiction (Substance Use Disorder) Counselor
3829MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mind at Ease Counseling and Wellness Mental Health CurrentSince Jul 22, 2025 Accepting new patients
Nuway Mental Health Clinic PastSince Aug 23, 2020 Accepting new patients

Organizations & group practices 2

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": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1417569765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8127 113TH STREET CT S",
            "city": "COTTAGE GROVE",
            "state": "MN",
            "postal_code": "550164511",
            "telephone_number": "612-275-2817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8127 113TH STREET CT S",
            "city": "COTTAGE GROVE",
            "state": "MN",
            "postal_code": "550164511",
            "telephone_number": "612-275-2817"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1619 Dayton Ave Ste 325",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551046495",
            "country_code": "US",
            "telephone_number": "763-228-4752",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2000 White Bear Ave N Unit 2",
            "address_purpose": "LOCATION",
            "city": "Maplewood",
            "state": "MN",
            "postal_code": "551093713",
            "country_code": "US",
            "telephone_number": "612-767-0300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCK",
        "first_name": "ERIN",
        "middle_name": "MICHELLE",
        "credential": "LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-18",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "305741",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "3829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "L352176881710",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottage Grove, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.