Individual provider Active NPI

Lauren Nicole Bergman, MA, LPCC

  • Professional Counselor
  • Coon Rapids, MN
National Provider Identifier
1649166117
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CC05003 Issued in MN
Practice address
11309 Bittersweet St NW
Coon Rapids, MN 55433-3559
Phone
(612) 293-5227
NPI assigned
Jun 13, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X CC05003 MN Primary

Addresses

Primary practice location

11309 Bittersweet St NW
Coon Rapids, MN 55433-3559

Mailing address

11309 Bittersweet St NW
Coon Rapids, MN 55433-3559
Phone (763) 354-8823

Other practice location 1

2324 University Ave W Ste 120
Saint Paul, MN 55114-1854
Phone (651) 644-4100

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251007000612 MN Practitioner - Mental Health Counselor 6507363785 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4220 31St Ave S
Minneapolis, MN 55406-3312
Phone (651) 208-2767

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
CC05003MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota Center for Psychology, LLC CurrentSince Sep 25, 2025 Accepting new patients
Twin Cities Counseling CurrentSince Jan 5, 2026 Accepting new patients

Locations

2324 University Ave W
Ste 120
Saint Paul, MN 55114
Phone (651) 644-4100

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1749772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1649166117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11309 BITTERSWEET ST NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554333559",
            "telephone_number": "763-354-8823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11309 BITTERSWEET ST NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554333559",
            "telephone_number": "612-293-5227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2324 University Ave W Ste 120",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551141854",
            "country_code": "US",
            "telephone_number": "651-644-4100",
            "fax_number": "651-644-4885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGMAN",
        "first_name": "LAUREN",
        "middle_name": "NICOLE",
        "credential": "MA, LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-13",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC05003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.