Taylor E Fellbaum-Wright, MS, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1702 Miller Trunk Hwy Ste 2
Duluth, MN 55811-4443

Phone

(218) 524-8889

NPI assigned

Oct 1, 2019

Last updated

Dec 26, 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 1

Addresses

Other names 1

• Taylor E Fellbaum Former name

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

Mental Health Counselor

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Nystrom & Associates, LTD

  dba Sagent Behavioral Health

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1569888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1649811670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW STE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121789",
            "telephone_number": "651-379-1756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 MILLER TRUNK HWY STE 2",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558114443",
            "telephone_number": "218-524-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELLBAUM-WRIGHT",
        "first_name": "TAYLOR",
        "middle_name": "E",
        "credential": "MS, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-01",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAYLOR",
            "last_name": "FELLBAUM",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elaheh Fekrazad
• Sara Ann Feldbrugge, PA-C
• Laura Jean Feldhake, AU.D.
• Harmony Feldman McCullough, LICSW
• Katie Feldt, OT
• Eve-Lynn R Fellersen
• Timothy Lyle Fellman, APRN, CNP
• Jeffrey Felt, MD
• Danyelle R Fenner, MD
• Grace Mae Fenske, DPT

• Mental Health Counselor in Duluth, MN
• Providers in Duluth, 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 Dec 26, 2024; 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.