KERRY LYNN VAN DUSEN (NPI# 1700919073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700919073 |
| Entity Type | Individual |
| Full Name | KERRY LYNN VAN DUSEN |
| Credential | PSYD LP |
| Practice Address |
101 W 2nd St Suite 100 Duluth MN 55802 |
| Practice Telephone | 2187403026 |
| Practice Fax Number | 2187403030 |
| Mailing Telephone | 2187403026 |
| Mailing Fax Number | 2187403030 |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
LP4115 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BCBS | 174M6N0 | 01 |
| MN | BCBS | 174M7VA | 01 |
| Street Address |
101 W 2ND ST SUITE 100 |
| City | DULUTH |
| State | MN |
| Zip Code | 55802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316570823 | Connie Rabideaux | Social Worker | 101 W 2nd St, Duluth, MN 55802-2086 | 2020-02-13 |
| 1316413982 | Dannillya Sperry | Behavior Technician | 101 W 2nd St, Duluth, MN 55802-2086 | 2018-10-22 |
| 1750857595 | Chelsea Weber | Counselor | 101 W 2nd St, Duluth, MN 55802-2086 | 2018-10-19 |
| 1336621085 | Daniel Rossow | Counselor | 101 W 2nd St, Duluth, MN 55802-2086 | 2018-08-29 |
| 1437636297 | Marie Gibson Adebisi | Counselor | 101 W 2nd St, Duluth, MN 55802-2086 | 2018-07-25 |
| 1194211268 | Jacob Eric Nustad-peluso | Counselor | 101 W 2nd St, Duluth, MN 55802-2086 | 2018-07-02 |
| 1275029357 | Cassidy Henriques | Behavior Technician | 101 W 2nd St, Duluth, MN 55802-2086 | 2018-07-02 |
| 1508350703 | Claire Nicole Ruegemer | Counselor | 101 W 2nd St, Duluth, MN 55802 | 2018-06-20 |
| 1245724186 | Stacey Kay Flom | Counselor | 101 W 2nd St, Duluth, MN 55802 | 2018-06-14 |
| 1336639137 | Lydia Walker | Counselor | 101 W 2nd St, Duluth, MN 55802 | 2018-05-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063915239 | Jpw Counseling & Consultation | Social Worker | 302 W Superior St Ste 508, Duluth, MN 55802 | 2018-03-14 |
| 1134664311 | Amp Group, LLC | Counselor | 331 West Superior Street, Duluth, MN 55802 | 2016-12-27 |
| 1982151361 | Tiffany Riester | Counselor | 332 W Superior Street, Suite 300, Duluth, MN 55802 | 2016-09-02 |
| 1730635392 | Karina Krosbakken | Counselor | 332 W. Superior St., Suite 300, Duluth, MN 55802 | 2016-09-01 |
| 1437559051 | Natalie R Zwak | Dietitian, Registered | 26 E Superior St Ste 315, Duluth, MN 55802 | 2014-09-02 |
| 1447679279 | Valerie Lou Shelton | Registered Nurse | 118 E Superior St., Duluth, MN 55802 | 2014-04-09 |
| 1285063115 | Brian Bergstedt | Counselor | 332 West Superior Street, Suite 300, Duluth, MN 55802 | 2013-11-01 |
| 1508135948 | Karen Dee Turner | Counselor | 202 W. Superior Street, Suite 700, Duluth, MN 55802 | 2011-12-14 |
| 1497023410 | Jean Barrie Mcbride | Pharmacist | 1131 East Superior Street, Duluth, MN 55802 | 2011-12-05 |
| 1194092304 | Diane Murphy Winship | Pharmacist | 1331 Superior St, Duluth, MN 55802 | 2011-11-17 |
| Find all providers in zip 55802 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053823104 | Laurel June Benoit | Psychologist | 324 W Superior St Ste 300, Duluth, MN 55802-1700 | 2017-10-30 |
| 1124539598 | Jonathan M Beyer | Psychologist | 324 W Superior St Ste 505, Duluth, MN 55802-1725 | 2017-10-12 |
| 1891957890 | Matthew Webb | Psychologist | 530 East Second Street, Duluth, MN 55805-1913 | 2008-06-30 |
| 1548469695 | Elizabeth Gene Burnett | Psychologist | 3305 Breckinridge Blvd Ste 116, Duluth, GA 30096-4932 | 2007-07-17 |
| 1265562755 | Sara Rebecca Dhuse | Psychologist | 4815 Burning Tree Rd Ste 200, Duluth, MN 55811-3833 | 2007-03-06 |
| 1518093640 | Katherine Marie Noonan | Psychologist | 3121 Amesbury Way, Duluth, GA 30096-5861 | 2007-02-25 |
| 1093881187 | Donald E Streufert | Psychologist | 205 West 2nd St, Suite 437 Duluth Psychological Clinic, Duluth, MN 55802 | 2006-11-28 |
| 1306912498 | Richard Ernest Duus | Psychologist | 205 West 2nd Street, Suite 437 Duluth Psychological Clinic, Duluth, MN 55802 | 2006-11-28 |
| 1912995838 | Jane Hovland | Psychologist | 1035 University Dr, 236 Center for Rural Mental Health Studies Med School, Duluth, MN 55812-3031 | 2005-10-13 |
| 1639789019 | Illume North, LLC | Psychologist | 324 W Superior St, 630 Medical Arts, Duluth, MN 55802-1701 | 2020-07-31 |
| Find all providers in DULUTH | ||||
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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.