Marisa Erickson

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC04197 Issued in MN

Practice address

11070 183Rd Cir NW Ste C
Elk River, MN 55330-3701

Phone

(763) 633-5111

NPI assigned

Jan 22, 2024

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hardy and Stephens Counseling Associates PLLCGroup PAC ID 6305201278, 9 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 and National Provider Directory roles.

• Hardy & Stephens Counseling Associates PLLC

  dba The Center for Hope and Healing

  • Mental Health Counselor
  • Elk River, MN
  • NPI 1871659623
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1705881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1730940370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11070 183RD CIR NW STE C",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553303701",
            "telephone_number": "763-633-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11070 183RD CIR NW STE C",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553303701",
            "telephone_number": "763-633-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "MARISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-22",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC04197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen English, MA, LPCC
• Stacey Dianne Engstrom
• Jenny E Enstrom, PA
• Charles Burton Erickson, MD
• Kendra Merrie Erickson
• Cyan Renae Evanoff
• Evans Park, Inc (Guardian Angels By The Lake)
• Evans Park, Inc.
• Brianna Faber
• Amy L Fair, M.D.

• Professional Counselor in Elk River, MN
• Providers in Elk River, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; 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.