Rebecca Michelle Anderson, LPCC, LADC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3283 Issued in MN

Practice address

716 Freeport Ave NW
Elk River, MN 55330-2645

Phone

(219) 595-2121

NPI assigned

May 3, 2022

Last updated

Mar 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Mind Body Mirror LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Otsego, MN
  • NPI 1922897917
  NPD Authorized official
• Parasol Wellness Collaborative

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Otsego, MN
  • NPI 1013376961
  NPD (past)

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

{
    "created_epoch": "1651536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1639814783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8808 373RD AVE NW",
            "city": "PRINCETON",
            "state": "MN",
            "postal_code": "553715512",
            "telephone_number": "651-210-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 FREEPORT AVE NW",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553302645",
            "telephone_number": "219-595-2121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9201 Quaday Ave NE Ste 205",
            "address_purpose": "LOCATION",
            "city": "Otsego",
            "state": "MN",
            "postal_code": "553306604",
            "country_code": "US",
            "telephone_number": "763-703-6962",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "REBECCA",
        "middle_name": "MICHELLE",
        "credential": "LPCC, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-03",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "3283",
            "primary": true
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Lyn Amundson, MS, LPCC
• Amy Nicole Anderson, LICSW
• Cathryn Delia Anderson
• Christine Marie Anderson, PT
• Cynthia Dennelle Anderson, RN
• Todd Anderson, DC
• Andest LLC
• Brady Michael Andvik, D.D.S.
• Sara Amanda-Ashley Annen
• Tyler Antony

• Professional Counselor in Elk River, MN
• Providers in Elk River, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; 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.