Active NPI
Brogan Renee Evenstad, LPCC
- Mental Health Counselor
- Rochester, MN
National Provider Identifier
1699362145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CC03014
- Practice address
- 300 1St Street NW
Suite 210
Rochester, MN 55901 - Phone
- (651) 233-3091
- NPI assigned
- Dec 30, 2020
- Last updated
- Apr 20, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Mental Health Counselor | 101YM0800X | CC03014 | MN | Primary |
Addresses
Primary practice location
300 1St Street NW
Suite 210
Rochester, MN 55901
Mailing address
300 1St Ave NW Ste 210
Rochester, MN 55901-2830
Phone (651) 233-3091
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CC03014 | MN | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sheila M. Daley, PLC | Current | Accepting new patients | |
| Onward Counseling PLLC | Mental Health | Current | Accepting new patients |
Locations
300 1st Ave NW
Ste 210
Rochester, MN 55901
Phone (507) 313-4731
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650412800000",
"number": "1699362145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 1ST AVE NW STE 210",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559012830",
"telephone_number": "651-233-3091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 1ST STREET NW",
"address_2": "SUITE 210",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "55901",
"telephone_number": "651-233-3091"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVENSTAD",
"first_name": "BROGAN",
"middle_name": "RENEE",
"credential": "LPCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-30",
"last_updated": "2022-04-20",
"certification_date": "2022-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "MN",
"license": "CC03014",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rochester, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.