TRINITY KYLYN BERGERON (NPI# 1639728280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639728280 |
| Entity Type | Individual |
| Full Name | TRINITY KYLYN BERGERON |
| Other Name | TRINITY KYLYN NESS |
| Credential | LADC |
| Practice Address |
722 15th St Nw Bemidji MN 56601-2528 |
| Mailing Address |
920 Feltl Ct Apt 310 Hopkins MN 55343-7972 |
| Practice Telephone | 2183332200 |
| Mailing Telephone | 2184071614 |
| Enumeration Date | 2019-09-06 |
| Last Update Date | 2019-09-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
305250 | MN | Behavioral Health & Social Service Providers |
| Street Address |
722 15TH ST NW |
| City | BEMIDJI |
| State | MN |
| Zip Code | 56601-2528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255431003 | Thomas Eugene Williams | Social Worker | 722 15th St Nw, Bemidji, MN 56601 | 2006-09-22 |
| 1588145270 | Katlyn Bowman | Registered Nurse | 722 15th St Nw, Bemidji, MN 56601-2528 | 2018-08-22 |
| 1770099731 | Shawna Marie Burnham | Counselor | 722 15th St Nw, Bemidji, MN 56601-2528 | 2017-12-28 |
| 1427567601 | Sanford Health of Northern Minnesota | Clinic/Center | 722 15th St Nw, Bemidji, MN 56601-2528 | 2017-09-20 |
| 1750819926 | Emily Celeste Barbot | Counselor | 722 15th St Nw, Bemidji, MN 56601-2528 | 2017-05-31 |
| 1730616962 | Marlin George Farley | Counselor | 722 15th St Nw, Bemidji, MN 56601-2528 | 2017-05-18 |
| 1114454345 | Rylie Dian Helweg | Counselor | 722 15th St Nw, Bemidji, MN 56601-2528 | 2017-05-18 |
| 1033646260 | Christopher Lee Slough | Counselor | 722 15th St Nw, Bemidji, MN 56601-2528 | 2017-05-18 |
| 1992239628 | Angela Rae Hiebsch | Counselor | 722 15th St Nw, Bemidji, MN 56601-2528 | 2017-04-19 |
| 1114461258 | Anna Chock | Counselor | 722 15th St Nw, Bemidji, MN 56601-2528 | 2016-12-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336772425 | Northern Minnesota Addiction Wellness Center | Substance Abuse Rehabilitation Facility | 4851 Stacy Ann Dr Nw, Bemidji, MN 56601 | 2020-02-17 |
| 1366093841 | Vickie Lynn Matthews | Technician | 1018 Miles Ave Se, Bemidji, MN 56601 | 2019-09-25 |
| 1518443530 | Lindsey Marie Whiting | Registered Nurse | 1300 Anne St, Bemidji, MN 56601 | 2018-07-12 |
| 1801257662 | Meghan Zigrida Paquette | Registered Nurse | 6055 161st Street Nw, Cass Lake, MN 56601 | 2016-03-08 |
| 1144686106 | Northwest Indian Oic | Home Health | 1819 Bemidji Ave N Ste 1, Bemidji, MN 56601 | 2016-01-06 |
| 1831560424 | Laura Hansen, Msw, Licsw Counseling Services, Inc. | Social Worker | 403 4th Street Ne, Suite 110, Bemidji, MN 56601 | 2015-10-08 |
| 1679949028 | Grand St. Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 2312 Bemidji Ave North, Bemidji, MN 56601 | 2015-08-19 |
| 1255717617 | Mary S. Salter, Md Psc | Internal Medicine | 514 Beltrami Ave Nw Suite 102, Bemidji, MN 56601 | 2015-08-07 |
| 1225420615 | Cristin Evans | Counselor | 403 4th Street, Suite 300, Bemidji, MN 56601 | 2015-02-23 |
| 1619367919 | Angela Krom Fournier | Psychologist | 16150 Golden Eagle Court Nw, Eagle Vista Equine Center Inc., Bemidji, MN 56601 | 2015-01-26 |
| Find all providers in zip 56601 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225420615 | Cristin Evans | Counselor | 403 4th Street, Suite 300, Bemidji, MN 56601 | 2015-02-23 |
| 1134410657 | Timothy John Warme | Counselor | 1001 Mississippi Ave Nw, Bemidji, MN 56601-4534 | 2011-05-02 |
| 1003139494 | Jessica L Scott | Counselor | 403 4th St Nw Ste 300, Bemidji, MN 56601-3196 | 2010-03-12 |
| 1023152667 | John Alexander Eric Graham | Counselor | 403 4th St Nw Ste 110, Bemidji, MN 56601-3155 | 2007-02-16 |
| 1407819758 | Jessica A. Dewey | Counselor | 1510 Bemidji Ave N, Suite #13, Bemidji, MN 56601-3800 | 2006-04-08 |
| 1356942452 | Amber Rai Whelan | Counselor | 403 4th St Nw Ste 300, Bemidji, MN 56601-3196 | 2020-11-04 |
| 1770099731 | Shawna Marie Burnham | Counselor | 722 15th St Nw, Bemidji, MN 56601-2528 | 2017-12-28 |
| 1194253021 | Bryan David Styve | Counselor | 1510 Bemidji Ave N Ste 13, Bemidji, MN 56601-3884 | 2017-05-23 |
| 1356878649 | Cody Lee Coyer | Counselor | 1510 Bemidji Ave N Ste 13, Bemidji, MN 56601-3884 | 2017-05-17 |
| 1538601778 | Great North Counseling Services, LLC | Counselor | 516 Beltrami Ave Nw, Bemidji, MN 56601-3010 | 2016-11-04 |
| Find all providers in BEMIDJI | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.