Individual provider Active NPI

Rebekah Hjermstad, LPCC

  • Professional Counselor
  • Edina, MN
National Provider Identifier
1710432935
Registry record updated Jan 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CC01284 Issued in MN
Practice address
7373 France Ave S Ste 302
Edina, MN 55435-4538
Phone
(952) 595-5652
NPI assigned
Aug 17, 2016
Last updated
Jan 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X CC01284 MN Primary

Addresses

Primary practice location

7373 France Ave S Ste 302
Edina, MN 55435-4538

Mailing address

7373 France Ave S Ste 302
Edina, MN 55435-4538
Phone (952) 595-5652

Other practice location 1

570 Professional Dr
Northfield, MN 55057-2756
Phone (507) 301-3412

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
I20240529000079 MN Practitioner - Mental Health Counselor 3173965761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
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)

17685 Juniper Path
Suite 303
Lakeville, MN 55044-9821
Phone (952) 214-8959

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CC01284MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates, LTD CurrentSince Sep 9, 2024 Accepting new patients
Secure Base Counseling Center LLC PastSince Mar 15, 2020 Accepting new patients

Locations

7300 147th St W
Ste 600
Apple Valley, MN 55124
Phone (952) 997-3020

1107 Hazeltine Blvd
Ste 370
Chaska, MN 55318
Phone (952) 204-7001

17685 Juniper Path
Ste 303
Lakeville, MN 55044
Phone (952) 214-8959

1101 E 78th St
Ste 100
Minneapolis, MN 55420
Phone (952) 234-8604

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

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": "1471392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674345600000",
    "number": "1710432935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7373 FRANCE AVE S STE 302",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354538",
            "telephone_number": "952-595-5652",
            "fax_number": "952-500-8167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7373 FRANCE AVE S STE 302",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354538",
            "telephone_number": "952-595-5652"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "570 Professional Dr",
            "address_purpose": "LOCATION",
            "city": "Northfield",
            "state": "MN",
            "postal_code": "550572756",
            "country_code": "US",
            "telephone_number": "507-301-3412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HJERMSTAD",
        "first_name": "REBEKAH",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-17",
        "last_updated": "2023-01-22",
        "certification_date": "2023-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC01284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.