Trilogy Counseling Services PLLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

00842 Issued in MN

Legal business name

TRILOGY COUNSELING SERVICES PLLC

Doing business as

Trilogy Counseling

Practice address

501 4TH St S Ste 201
Princeton, MN 55371-4754

Phone

(763) 498-1822

NPI assigned

May 25, 2018

Last updated

Jun 14, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jacqueline Kelly-Faddler, LPCCNPI 1881020527

Title

Owner

Phone

(763) 498-1822

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Trilogy Counseling Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jacqueline Kelly-Faddler, MS, LPCC

  • Professional Counselor
  • Princeton, MN
  • NPI 1881020527
  Medicare reassignment NPD Authorized official
• Tanya Anne Lambert, MS, LPCC

  • Mental Health Counselor
  • Elk River, MN
  • NPI 1679929640
  Medicare reassignment NPD
• Sara Goudge, MA, LPCC

  • Professional Counselor
  • Saint Francis, MN
  • NPI 1083991525
  NPD (past)
• Ashley Johnson

  • Professional Counselor
  • Little Canada, MN
  • NPI 1629667258
  NPD (past)

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

{
    "created_epoch": "1527206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718323200000",
    "number": "1497246433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 4TH ST S STE 201",
            "city": "PRINCETON",
            "state": "MN",
            "postal_code": "553714754",
            "telephone_number": "763-498-1822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 4TH ST S STE 201",
            "city": "PRINCETON",
            "state": "MN",
            "postal_code": "553714754",
            "telephone_number": "763-498-1822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3325 Bridge St NW",
            "address_purpose": "LOCATION",
            "city": "Saint Francis",
            "state": "MN",
            "postal_code": "550708200",
            "country_code": "US",
            "telephone_number": "763-498-1822",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "657 Main St NW Ste 211",
            "address_purpose": "LOCATION",
            "city": "Elk River",
            "state": "MN",
            "postal_code": "553301579",
            "country_code": "US",
            "telephone_number": "763-498-1822",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "80 County Road C W",
            "address_purpose": "LOCATION",
            "city": "Little Canada",
            "state": "MN",
            "postal_code": "551171345",
            "country_code": "US",
            "telephone_number": "763-498-1822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRILOGY COUNSELING SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-25",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A",
        "authorized_official_last_name": "KELLY-FADDLER",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-498-1822",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "00842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497246433",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://trilogycounselingmn.com/contact/",
            "affiliation": "N",
            "address_1": "501 4th St S Ste 201",
            "city": "Princeton",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553714754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Trilogy Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James Tich Jr.
• Christine Rose Tobin, AU.D
• Amanda Torgeson, D.O.
• Nicole Trettel
• Jordanai Anne Treuber
• Urology Associates, LTD.
• Theodore P Vanerp, MD
• Steven Craig Vanhooser, DC
• Alaina Jean Verkinnes, MA CCC-SLP
• Abby Marie Vermilyea, PT, DPT

• Professional Counselor in Princeton, MN
• Providers in Princeton, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.