Active NPI
Ross G Mickelson, LPCC
- Professional Counselor
- Minneapolis, MN
National Provider Identifier
1861135048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1029-9-15-19-458
- Practice address
- 115 N 2ND St Apt 311
Minneapolis, MN 55401-2768 - Phone
- (218) 234-6789
- NPI assigned
- Apr 15, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 1029-9-15-19-458 | ND | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Mental Health Counselor | 101YM0800X | 1029-9-15-19-458 | ND | |
| Specialist | 174400000X | 1029-9-15-19-458 | ND |
Addresses
Primary practice location
115 N 2ND St Apt 311
Minneapolis, MN 55401-2768
Mailing address
25545 River Hills LN
Detroit Lakes, MN 56501-7165
Phone (218) 234-6789
Other practice location 1
2888 Brandt Dr S Apt 108
Fargo, ND 58104-9066
Phone (218) 234-6789
Other practice location 2
1041 Hawk St
Detroit Lakes, MN 56501-6958
Phone (218) 287-4338
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nuvation Health Services P.C. | Mental Health | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788220800000",
"number": "1861135048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25545 RIVER HILLS LN",
"city": "DETROIT LAKES",
"state": "MN",
"postal_code": "565017165",
"telephone_number": "218-234-6789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 N 2ND ST APT 311",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554012768",
"telephone_number": "218-234-6789"
}
],
"practiceLocations": [
{
"address_1": "2888 Brandt Dr S Apt 108",
"address_purpose": "LOCATION",
"city": "Fargo",
"state": "ND",
"postal_code": "581049066",
"country_code": "US",
"telephone_number": "218-234-6789",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1041 Hawk St",
"address_purpose": "LOCATION",
"city": "Detroit Lakes",
"state": "MN",
"postal_code": "565016958",
"country_code": "US",
"telephone_number": "218-287-4338",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MICKELSON",
"first_name": "ROSS",
"middle_name": "G",
"name_prefix": "Mr.",
"credential": "LPCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-04-15",
"last_updated": "2026-09-01",
"certification_date": "2026-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ND",
"license": "1029-9-15-19-458",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ND",
"license": "1029-9-15-19-458",
"primary": false
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "ND",
"license": "1029-9-15-19-458",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.