Individual provider Active NPI

Nolan J Ewert

  • Mental Health Counselor
  • Duluth, MN
National Provider Identifier
1689498776
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2997 Issued in MN
Practice address
120 W 2ND St
Duluth, MN 55802-2017
Phone
(218) 728-4491
Fax
(218) 302-8698
NPI assigned
Nov 14, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2997 MN Primary

Addresses

Primary practice location

120 W 2ND St
Duluth, MN 55802-2017

Mailing address

1401 East 1St Street
Duluth, MN 55805-2407
Phone (218) 728-4491

Other practice location 1

40 11th St
Cloquet, MN 55720-1817
Phone (218) 879-4559

Other practice location 2

1401 East 1st Street
Duluth, MN 55805-2407
Phone (218) 728-4491

Other practice location 3

810 E 4th St
Duluth, MN 55805-2147
Phone (218) 728-4491

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
I20250213001781 MN Practitioner - Mental Health Counselor 5799215208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Human Development CenterGroup PAC ID 2961485909, 39 clinicians

Practice addresses (Care Compare)

120 W 2ND St
Duluth, MN 55802-2017
Phone (218) 728-4491

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2997MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brightwater Health Dba Human Development Center CurrentSince Jan 1, 2025 Accepting new patients
Brightwater Health Dba Human Development Center PastSince Jan 1, 2025 Accepting new patients

Locations

40 11th St
Cloquet, MN 55720
Phone (218) 879-4559

1401 E 1st St
Duluth, MN 55805
Phone (218) 728-4491

810 E 4th St
Duluth, MN 55805
Phone (218) 728-4491

120 W 2nd St
Duluth, MN 55802
Phone (218) 728-4491

629 1st Ave
Two Harbors, MN 55616
Phone (218) 834-5520

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/humandevelopmentcenter/r4/

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": "1731542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1689498776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 EAST 1ST STREET",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052407",
            "telephone_number": "218-728-4491",
            "fax_number": "218-302-8698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W 2ND ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022017",
            "telephone_number": "218-728-4491",
            "fax_number": "218-302-8698"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 11th St",
            "address_purpose": "LOCATION",
            "city": "Cloquet",
            "state": "MN",
            "postal_code": "557201817",
            "country_code": "US",
            "telephone_number": "218-879-4559",
            "fax_number": "218-879-0282",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1401 East 1st Street",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558052407",
            "country_code": "US",
            "telephone_number": "218-728-4491",
            "fax_number": "218-302-8698",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "810 E 4th St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558052147",
            "country_code": "US",
            "telephone_number": "218-728-4491",
            "fax_number": "218-302-8698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EWERT",
        "first_name": "NOLAN",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-14",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "2997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.