NPIMap

Organization Active NPI

Superior Counseling LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Duluth, MN
National Provider Identifier
1851940621
Registry record updated Sep 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SUPERIOR COUNSELING LLC
Practice address
324 W Superior St Ste 530
Duluth, MN 55802-1724
Phone
(218) 590-9556
Fax
(218) 600-5009
NPI assigned
Sep 5, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2019

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

Authorized official

Name
Andrea N Wells, MSW, LICSWNPI 1194275537
Title
Psychotherapist/Supervisor
Phone
(218) 590-9556

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

324 W Superior St Ste 530
Duluth, MN 55802-1724

Mailing address

324 W Superior St Ste 530
Duluth, MN 55802-1724
Phone (218) 590-9556

Other practice location 1

199 Chestnut Ave
Carlton, MN 55718-2016
Phone (218) 464-7674

Other names 1

  • Superior Counseling Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220207000987 MN Part B Supplier - Clinic/Group Practice 9830582386 Receives reassigned benefits from 7 practitioners
Practice locations: Duluth, MN

National Provider Directory

National Provider Directory

Locations

199 Chestnut Ave
Carlton, MN 55718
Phone (218) 464-7674

324 W Superior St
Ste 530
Duluth, MN 55802
Phone (218) 464-7674

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567641600000",
    "number": "1851940621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 W SUPERIOR ST STE 530",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021724",
            "telephone_number": "218-590-9556",
            "fax_number": "218-600-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 W SUPERIOR ST STE 530",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021724",
            "telephone_number": "218-590-9556",
            "fax_number": "218-600-5009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "199 Chestnut Ave",
            "address_purpose": "LOCATION",
            "city": "Carlton",
            "state": "MN",
            "postal_code": "557182016",
            "country_code": "US",
            "telephone_number": "218-464-7674",
            "fax_number": "218-600-5009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUPERIOR COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-05",
        "last_updated": "2019-09-05",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST/SUPERVISOR",
        "authorized_official_telephone_number": "218-590-9556",
        "authorized_official_credential": "MSW, LICSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Superior Counseling",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.