Erika Marie Severson, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

20630 Issued in MN

Practice address

1422 Central Ave NW
East Grand Forks, MN 56721

Phone

(218) 281-3940

NPI assigned

Aug 9, 2013

Last updated

Jun 22, 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 2

Addresses

Other names 1

• Erika Marie Rustad Former name

Electronic endpoints 1

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

Clinical Social Worker

Education

University of North Dakota School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Alluma IncGroup PAC ID 6709787609, 23 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.

• Alluma, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Crookston, MN
  • NPI 1508835133
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1376006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1770916025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567160603",
            "telephone_number": "218-281-3940",
            "fax_number": "218-281-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1422 CENTRAL AVE NW",
            "city": "EAST GRAND FORKS",
            "state": "MN",
            "postal_code": "56721",
            "telephone_number": "218-281-3940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "603 Bruce Street",
            "address_purpose": "LOCATION",
            "city": "Crookston",
            "state": "MN",
            "postal_code": "567160603",
            "country_code": "US",
            "telephone_number": "218-281-3940",
            "fax_number": "218-281-6261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEVERSON",
        "first_name": "ERIKA",
        "middle_name": "MARIE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-09",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "20630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "otherurl",
            "affiliation": "N",
            "address_1": "1422 Central Ave NW",
            "city": "East Grand Forks",
            "state": "MN",
            "country_code": "US",
            "postal_code": "56721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ERIKA",
            "last_name": "RUSTAD",
            "middle_name": "MARIE",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Clinical Social Worker in East Grand Forks, MN
• Providers in East Grand Forks, MN by specialty
• Clinical Social Worker in Minnesota

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