Deborah A Rudningen, LPC, LADC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC00963 Issued in MN

Practice address

10010 Strawberry Lake Rd
Pequot Lakes, MN 56472-2291

Phone

(218) 833-7636

Fax

(218) 543-4394

NPI assigned

Jul 12, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Changing Strides Therapy LLC

  • Mental Health Counselor
  • Pequot Lakes, MN
  • NPI 1487001400
  NPD
• Raymone Kral & Associates LLC

  • Community/Behavioral Health Agency
  • Duluth, MN
  • NPI 1568430635

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1373587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1508207044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10010 STRAWBERRY LAKE RD",
            "city": "PEQUOT LAKES",
            "state": "MN",
            "postal_code": "564722291",
            "telephone_number": "218-833-7636",
            "fax_number": "218-543-4394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10010 STRAWBERRY LAKE RD",
            "city": "PEQUOT LAKES",
            "state": "MN",
            "postal_code": "564722291",
            "telephone_number": "218-833-7636",
            "fax_number": "218-543-4394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDNINGEN",
        "first_name": "DEBORAH",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LPC, LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-12",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303570",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "01317",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC00963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pequot Lakes Chiropractic PA
• Pequot Lakes Physical Therapy Services, Inc
• Erin Person-Witt
• Scott Kermit Peterson, RN
• Cynthia L. Rieck, PT
• Angela Sandelin
• Select Therapy, Inc.
• Select Therapy, Inc.
• Senior Class Care of Pequot Lakes, Inc.
• Senior Class Community, LLC

• Mental Health Counselor in Pequot Lakes, MN
• Providers in Pequot Lakes, 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 Nov 4, 2021; 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.