Trinity Kylyn Bergeron, LADC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Bemidji, MN
NPI 1639728280 · NPPES record last updated Jun 30, 2021
Key facts
- NPI
- 1639728280
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 305250 (MN)
- Practice address
- 403 4TH St NW Ste 300
Bemidji, MN 56601-3196 - Phone
- (218) 444-5155
- Fax
- (218) 333-3921
- NPI assigned
- Sep 6, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 305250 | MN | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 305250 | MN | Yes |
Addresses
Primary practice location
403 4TH St NW Ste 300
Bemidji, MN 56601-3196
Mailing address
403 4TH St NW Ste 300
Bemidji, MN 56601-3196
Phone (218) 407-1614
Other names
- Trinity Kylyn Ness
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | trinity.bergeron@sandfordhealth.org |
Other providers in Bemidji, MN
- Winston Craig Benson
- Cassidy Marie Bera
- Elizabeth Bernice Berg
- Sarah Berg
- Wanda Kay Berg
- Megan Jo Betters
- Shristi Bhattarai
- Wesley James Bickler
- Binesiikweg, Inc.
- Adam Birch
All providers in Bemidji, MN · Addiction (Substance Use Disorder) Counselor in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.