Individual provider Active NPI

Susan Lyn Brown, LADC, LSW

  • Addiction (Substance Use Disorder) Counselor
  • Red Wing, MN
National Provider Identifier
1467990622
Registry record updated Feb 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
301700 Issued in MN
Practice address
1614 W 3Rd St
Red Wing, MN 55066-2086
Phone
(651) 327-2770
Fax
(651) 327-2771
NPI assigned
Feb 8, 2017
Last updated
Feb 8, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2017

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 301700 MN Primary
Social Worker 104100000X 13727 MN

Addresses

Primary practice location

1614 W 3Rd St
Red Wing, MN 55066-2086

Mailing address

PO Box 298
Solon Springs, WI 54873-0298
Phone (651) 245-9648

Other identifiers 1

IdentifierTypeStateIssuer
301700OtherMNLADC LICENSE NUMBER

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
301700MNMDAddiction (Substance Use Disorder) Counselor
13727MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
No Other Way (Now) Recovery Services LLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486512000000",
    "number": "1467990622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 298",
            "city": "SOLON SPRINGS",
            "state": "WI",
            "postal_code": "548730298",
            "telephone_number": "651-245-9648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1614 W 3RD ST",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550662086",
            "telephone_number": "651-327-2770",
            "fax_number": "651-327-2771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "SUSAN",
        "middle_name": "LYN",
        "credential": "LADC, LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-08",
        "last_updated": "2017-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "301700",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "13727",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LADC LICENSE NUMBER",
            "identifier": "301700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Wing, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2017; 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.