Rebecca Sue Paulon, LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

303412 Issued in MN

Practice address

6448 Main Street
Suites 1 and 3
North Branch, MN 55056

Phone

(651) 775-9804

Fax

(844) 364-7181

NPI assigned

Sep 16, 2022

Last updated

Sep 16, 2022By the provider in NPPES

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

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

Marriage and Family Therapist

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

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.

• Canvas Health, Inc.

  • Mental Health Counselor
  • Oakdale, MN
  • NPI 1922051325
  Medicare reassignment NPD

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

{
    "created_epoch": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1821710740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "city": "NORTH BRANCH",
            "state": "MN",
            "postal_code": "550560547",
            "telephone_number": "651-775-9804",
            "fax_number": "844-364-7181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6448 MAIN STREET",
            "address_2": "SUITES 1 AND 3",
            "city": "NORTH BRANCH",
            "state": "MN",
            "postal_code": "55056",
            "telephone_number": "651-775-9804",
            "fax_number": "844-364-7181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULON",
        "first_name": "REBECCA",
        "middle_name": "SUE",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-16",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.theraplacemn.com",
            "affiliation": "N",
            "endpointDescription": "address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "useOtherDescription": "address",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "address",
            "address_1": "6448 Main St Ste 1And3",
            "city": "North Branch",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550567068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Janice Larayne Olson, LPC
• Sandra Kay Olson, RN
• Tiffany Oslin, CNP
• Outlook Health Services, Inc.
• Briana Paige
• Perreault Chiropractic and Acupuncture Service Corporation (Perreault Chiropractic & Acupuncture)
• Michael Bahr Perry
• Donald Richard Peters
• Phoenix
• Phoenix Academy of Art and Science

• Addiction (Substance Use Disorder) Counselor in North Branch, MN
• Providers in North Branch, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; 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.