Courtney Van Den Bussche-Doll, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC02001 Issued in MN

Practice address

1041 Hawk St
Detroit Lakes, MN 56501-6958

Phone

(218) 844-6853

Fax

(218) 844-6854

NPI assigned

Dec 11, 2018

Last updated

Oct 27, 2021By 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

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shari Phillips, LLCGroup PAC ID 9537509336, 8 clinicians

Naturally Connected Counseling LLCGroup PAC ID 1951842491, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Shari Phillips LLC

  dba Imagine Mental Health Counseling

  • Mental Health Counselor
  • Wadena, MN
  • NPI 1023691896
  Medicare reassignment Care Compare group NPD
• Naturally Connected Counseling LLC

  • Adult Mental Health Clinic/Center
  • Milaca, MN
  • NPI 1245960442
  Medicare reassignment Care Compare group
• Solutions Behavioral Healthcare Professionals, PC

  dba Solutions Behavioral Healthcare Professionals

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Moorhead, MN
  • NPI 1801909239
  NPD
• Lakes Crisis & Resource Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Detroit Lakes, MN
  • NPI 1720344286
  NPD (past)

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

{
    "created_epoch": "1544486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1699246983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1547 30TH AVE S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565605149",
            "telephone_number": "218-287-4338",
            "fax_number": "218-287-5928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 HAWK ST",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565016958",
            "telephone_number": "218-844-6853",
            "fax_number": "218-844-6854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DEN BUSSCHE-DOLL",
        "first_name": "COURTNEY",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-11",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC02001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Tjepkes
• Carrie A Tobkin, PT
• James J Torkildson, ED.D.
• Thomas N. Truedson, LAT, ATC
• Allison Rae Uselman
• Kateri Vanraden
• Linda Rae Vanroekel Kuismi, RNC/FNP
• Aaron A Vasa, MD
• Julia Gabriela Vasquez Lopez, MD
• Jaylen Voigt

• Professional Counselor in Detroit Lakes, MN
• Providers in Detroit Lakes, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.