Laine Cecily Hartwell Bermansohn, LPCC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

CC01900 Issued in MN

Practice address

5354 Parkdale Drive
2ND Floor
St. Louis Park, MN 55416

Phone

(651) 645-5323

Fax

(952) 746-5962

NPI assigned

Jun 22, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Laine Cecily Hartwell Epp Former name

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Radiant Recovery and Counseling ServicesGroup PAC ID 2860932803, 2 clinicians

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 and National Provider Directory roles.

• Nystrom & Associates, LTD

  dba Sagent Behavioral Health

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  Medicare reassignment Care Compare group NPD
• Radiant Recovery & Counseling Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Minneapolis, MN
  • NPI 1699470450
  Medicare reassignment Care Compare group NPD
• Emily Program P C

  dba The Emily Program

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Paul, MN
  • NPI 1528165065
  Medicare reassignment NPD

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1841641743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5354 PARKDALE DRIVE 2ND FLOOR",
            "city": "ST. LOUIS PARK",
            "state": "MN",
            "postal_code": "55416",
            "telephone_number": "952-652-7452",
            "fax_number": "952-746-5962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5354 PARKDALE DRIVE",
            "address_2": "2ND FLOOR",
            "city": "ST. LOUIS PARK",
            "state": "MN",
            "postal_code": "55416",
            "telephone_number": "651-645-5323",
            "fax_number": "952-746-5962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMANSOHN",
        "first_name": "LAINE",
        "middle_name": "CECILY HARTWELL",
        "name_prefix": "Ms.",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-22",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "01907",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "CC01900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAINE",
            "last_name": "EPP",
            "middle_name": "CECILY HARTWELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristen Berglie
• Jack William Bergman, PA-C
• Rogene L Tweeten Bergquist, MSSW
• Michelle Renee Bergren, P.T.
• Kristin Berling, OTR/L
• Susan J Bermel, CRNA
• Carrie Rose Berndt Alonso, LPN
• Chloe N Bernens, PA-C
• Sharon Lee Berry, PHD, LP, ABPP
• Kathryn Jean Berscheit, CNM

• Counseling Psychologist in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Counseling Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; 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.