Eric Joseph Trudell, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

20921 Issued in MN

Practice address

237 2ND Ave SW Ste 117
Cambridge, MN 55008-1500

Phone

(763) 780-1520

NPI assigned

Aug 8, 2013

Last updated

Oct 4, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Based Therapy AssociatesGroup PAC ID 2264432681, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Family Based Therapy Associates

  • Mental Health Counselor
  • Coon Rapids, MN
  • NPI 1194762005
  Medicare reassignment Care Compare group NPD
• Family Based Therapy Associates

  • Community/Behavioral Health Agency
  • Chisago City, MN
  • NPI 1891100293
  NPD (past)

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

{
    "created_epoch": "1375920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1598197865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 2ND AVE SW STE 117",
            "city": "CAMBRIDGE",
            "state": "MN",
            "postal_code": "550081500",
            "telephone_number": "763-780-1520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 2ND AVE SW STE 117",
            "city": "CAMBRIDGE",
            "state": "MN",
            "postal_code": "550081500",
            "telephone_number": "763-780-1520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUDELL",
        "first_name": "ERIC",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-08",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "20921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Thomsen
• Leah Thoreson
• Mary Thorkildson
• Ruth Mae Tomczyk, RPH
• Thomas M Trempe, PHARMD
• Chad Vu Truong
• Tara Jean Tuveson
• Wendi Tvedt
• Bethany Marie Undis, CRNA
• Kevin W Unger, MD

• Clinical Social Worker in Cambridge, MN
• Providers in Cambridge, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.