Dustin Ericson, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

3890 Issued in MN

Practice address

2424 Business 371
Brainerd, MN 56401-8306

Phone

(218) 833-8790

NPI assigned

Apr 9, 2021

Last updated

Apr 9, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minnesota Teen Challenge, IncGroup PAC ID 0840656856, 22 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.

• Minnesota Teen Challenge, Inc

  dba Minnesota Adult & Teen Challenge

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Minneapolis, MN
  • NPI 1831574797
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1617926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1871173369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 BUSINESS 371",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564018306",
            "telephone_number": "218-833-8790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 BUSINESS 371",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564018306",
            "telephone_number": "218-833-8790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICSON",
        "first_name": "DUSTIN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-09",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harley Lyell Ellis, RN, CNP
• Patricia Kastens Engelstad, CRNA
• Scott E Engelstad, CRNA
• Colleen Elizabeth Erickson, LICSW
• Melissa Ann Erickson, APRN, CNP
• Randa Ericson
• Diana Espana Neubauer, APRN,CNP
• Kelsi L Evans, RN, PMHNP
• Faith Counseling and Wellness, LLC (Faith Counseling and Wellness)
• Kendall Gregory Fancher, MD

• Marriage & Family Therapist in Brainerd, MN
• Providers in Brainerd, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.