Individual provider Active NPI

Michelle Erin Lamusga, MA, LPCC, LPC, LADC

  • Mental Health Counselor
  • Baxter, MN
National Provider Identifier
1710265376
Registry record updated Feb 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CC00331 Issued in MN
Practice address
13045 Falcon Dr Ste 100
Baxter, MN 56425-4201
Phone
(218) 829-9307
Fax
(218) 829-7649
NPI assigned
Aug 1, 2011
Last updated
Feb 20, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2019

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 CC00331 MN Primary

Addresses

Primary practice location

13045 Falcon Dr Ste 100
Baxter, MN 56425-4201

Mailing address

821 W Saint Germain St
Saint Cloud, MN 56301-3536
Phone (320) 259-5381

Other practice location 1

821 W Saint Germain St
Saint Cloud, MN 56301-3536
Phone (320) 259-5381

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
I20240101000285 MN Practitioner - Mental Health Counselor 9931559135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians

Practice addresses (Care Compare)

13045 Falcon Dr
Suite 100
Baxter, MN 56425-4201
Phone (218) 829-9307

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CC00331MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates, LTD CurrentSince Jan 1, 2024 Accepting new patients

Locations

13045 Falcon Dr
#100
Brainerd, MN 56425
Phone (218) 203-6282

1900 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (651) 379-1704

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

Organizations & group practices 1

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": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1710265376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 W SAINT GERMAIN ST",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563013536",
            "telephone_number": "320-259-5381",
            "fax_number": "320-259-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13045 FALCON DR STE 100",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564254201",
            "telephone_number": "218-829-9307",
            "fax_number": "218-829-7649"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "821 W Saint Germain St",
            "address_purpose": "LOCATION",
            "city": "Saint Cloud",
            "state": "MN",
            "postal_code": "563013536",
            "country_code": "US",
            "telephone_number": "320-259-5381",
            "fax_number": "320-259-6171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAMUSGA",
        "first_name": "MICHELLE",
        "middle_name": "ERIN",
        "credential": "MA, LPCC, LPC, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-01",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC00331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baxter, MN

Sources for this page

Verify at the official NPI Registry.