| Two Rivers Counseling LLC | |
|
404 W Superior St Ste 210 Duluth MN 55802-1569 | |
| (218) 606-1100 | |
| (218) 520-1799 |
| Full Name | Two Rivers Counseling LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 404 W Superior St Ste 210, Duluth, Minnesota |
| Authorized Official Name and Position | Eve-lynn R Fellersen (OWNER) |
| Authorized Official Contact | 2186061100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Two Rivers Counseling LLC 404 W Superior St Ste 210 Duluth MN 55802-1569 Ph: (218) 606-1100 | Two Rivers Counseling LLC 404 W Superior St Ste 210 Duluth MN 55802-1569 Ph: (218) 606-1100 |
| NPI Number | 1093486722 |
|---|---|
| Provider Enumeration Date | 09/22/2021 |
| Last Update Date | 02/04/2023 |
| Certification Date | 02/04/2023 |
| Medicare PECOS PAC ID | 7416322268 |
|---|---|
| Medicare Enrollment ID | O20230407001195 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093486722 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (NU) | Primary |
| 251S00000X | Community/behavioral Health | (NU) | Secondary |
| Provider Name | Richard E Mosher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366860041 PECOS PAC ID: 3779801287 Enrollment ID: I20150414000337 |
| Provider Name | Lindsay Marie Matti |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962938704 PECOS PAC ID: 0446586135 Enrollment ID: I20190802000961 |
| Provider Name | Heidi Louise Wendorf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528684446 PECOS PAC ID: 9234554387 Enrollment ID: I20200806000461 |
| Provider Name | Natalie Jo Ryan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023680550 PECOS PAC ID: 6204239312 Enrollment ID: I20210727003862 |
| Provider Name | Deborah Becker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083375547 PECOS PAC ID: 8527438142 Enrollment ID: I20221222002492 |
| Provider Name | Ina Newton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043936875 PECOS PAC ID: 6204201411 Enrollment ID: I20230331000268 |
| Provider Name | Rebekah a Dockendorf |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639860299 PECOS PAC ID: 7315304722 Enrollment ID: I20230530003041 |
| Provider Name | Lindsay Rae Hansen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417724550 PECOS PAC ID: 0749630580 Enrollment ID: I20231220001587 |
| Provider Name | Kelly Ann Evertz |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1033827233 PECOS PAC ID: 1456701481 Enrollment ID: I20240103000706 |
| Provider Name | Richard Fredolph Tunell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265174387 PECOS PAC ID: 4880045541 Enrollment ID: I20240105004051 |
| Provider Name | Eve-lynn R Fellersen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740744853 PECOS PAC ID: 0143695999 Enrollment ID: I20240108004705 |
| Provider Name | Ashely Skadsem |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134652068 PECOS PAC ID: 6002251139 Enrollment ID: I20240228004469 |
| Provider Name | Alexis Nicole Jacobson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083372106 PECOS PAC ID: 3476992470 Enrollment ID: I20240423002051 |
| Provider Name | Cortney Ruth Buchholz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558655894 PECOS PAC ID: 8123562253 Enrollment ID: I20240701001737 |
| Provider Name | Hollyann Loraine Chan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619728250 PECOS PAC ID: 5294258570 Enrollment ID: I20250327001102 |
| Provider Name | Kathleen Ann Mccarty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841071677 PECOS PAC ID: 9436632007 Enrollment ID: I20260311003456 |
| Provider Name | Shiloh Scherf Hammond |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811741051 PECOS PAC ID: 6406339688 Enrollment ID: I20260316002801 |
| Provider Name | Augustus Kjolhaug |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114641537 PECOS PAC ID: 4183108707 Enrollment ID: I20260323000567 |
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