Julie Iverson

Primary specialty

CounselorTaxonomy code 101Y00000X

License

CC02411 Issued in MN

Practice address

11660 Round Lake Blvd NW
Coon Rapids, MN 55433-2638

Phone

(763) 767-3350

NPI assigned

Jul 7, 2015

Last updated

Mar 27, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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, 2007

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)

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.

• Nystrom & Associates, LTD

  dba Sagent Behavioral Health

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  Medicare reassignment Care Compare group NPD
• River Counseling, LLC

  dba River Counseling

  • Adult Mental Health Clinic/Center
  • Maple Grove, MN
  • NPI 1457502577
  NPD (past)

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585267200000",
    "number": "1730562919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19877 JACKSON ST NE",
            "city": "EAST BETHEL",
            "state": "MN",
            "postal_code": "550119580",
            "telephone_number": "612-636-6127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11660 ROUND LAKE BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332638",
            "telephone_number": "763-767-3350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "711 6th Ave NE",
            "address_purpose": "LOCATION",
            "city": "Isanti",
            "state": "MN",
            "postal_code": "550403207",
            "country_code": "US",
            "telephone_number": "763-444-5567",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IVERSON",
        "first_name": "JULIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-07",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MN",
            "license": "CC02411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neal Irion, DT
• Nasro Abdinur Isaq, MD
• Mohamed Ali Ismail
• Olukole K Israel Payne
• Mari B Ito, MD
• Katelyn Magnan Iverson, LPCC
• Sandra L Iverson, CPNP
• Jewelle Ruth Jacklen, ATC
• Jessica M Jacklitch, PT
• Deborah Jacobi, RDH

• Counselor in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2020; 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.