Individual provider Active NPI

Angela Christine Newstrom, M.S., LPCC

  • Counselor
  • Minneapolis, MN
National Provider Identifier
1437569159
Registry record updated Aug 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
CC00697 Issued in MN
Practice address
1516 W Lake St
Suite 110
Minneapolis, MN 55408-2554
Phone
(612) 822-1357
Fax
(612) 822-1360
NPI assigned
May 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CC00697 MN Primary

Addresses

Primary practice location

1516 W Lake St
Suite 110
Minneapolis, MN 55408-2554

Mailing address

2712 Fremont Ave S
Minneapolis, MN 55408-1122
Phone (612) 872-8218

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CC00697MNMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Cerebral Palsy, Inc CurrentSince Mar 21, 2024 Accepting new patients
Upstate Cerebral Palsy, Inc. CurrentSince Mar 21, 2024 Accepting new patients

Locations

125 Business Park Dr
Utica, NY 13502
Phone (315) 724-6907

1002 Oswego St
Utica, NY 13502
Phone (315) 798-8868

1601 Armory Dr
Utica, NY 13501
Phone (315) 798-4006

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": "1398988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471564800000",
    "number": "1437569159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2712 FREMONT AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554081122",
            "telephone_number": "612-872-8218",
            "fax_number": "612-874-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 W LAKE ST",
            "address_2": "SUITE 110",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082554",
            "telephone_number": "612-822-1357",
            "fax_number": "612-822-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWSTROM",
        "first_name": "ANGELA",
        "middle_name": "CHRISTINE",
        "credential": "M.S., LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-02",
        "last_updated": "2016-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MN",
            "license": "CC00697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.