Shanna Van Duzer, MA, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC02307 Issued in MN

Practice address

7041 20TH Ave
Centerville, MN 55038-9737

Phone

(651) 407-3631

NPI assigned

Jan 23, 2020

Last updated

Jan 23, 2020By 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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Nystrom & Associates, LTD

  dba Sagent Behavioral Health

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  Medicare reassignment NPD
• Family Innovations, Inc.

  dba LifeStance Health

  • Counseling Psychologist
  • Anoka, MN
  • NPI 1992862783

  Professional

  NPD

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1942830443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7041 20TH AVE",
            "city": "CENTERVILLE",
            "state": "MN",
            "postal_code": "550389737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7041 20TH AVE",
            "city": "CENTERVILLE",
            "state": "MN",
            "postal_code": "550389737",
            "telephone_number": "651-407-3631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DUZER",
        "first_name": "SHANNA",
        "credential": "MA, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-23",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC02307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie Ann Schleifer
• Nancy Kay Schwartz
• Sisu Therapy, PLLC
• Kimberly Kay Surve, LMFT
• Autumn Terlouw
• Xong Vang
• Andrea Veech, LPCC
• Jenna Vissell
• Timothy Brian Walsh, LP
• Jari Lynn Welle, LMFT

• Professional Counselor in Centerville, MN
• Providers in Centerville, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.