MATTHEW AARON FANBERG (NPI# 1447750294) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447750294 |
| Entity Type | Individual |
| Full Name | MATTHEW AARON FANBERG |
| Credential | MSED, LPCC |
| Practice Address |
332 W Superior St Ste 300 Duluth MN 55802-1844 |
| Mailing Address |
1900 Silver Lake Rd Nw Ste 110 New Brighton MN 55112-1789 |
| Practice Telephone | 2187224379 |
| Practice Fax Number | 2187224333 |
| Mailing Telephone | 6516289566 |
| Mailing Fax Number | 6516280411 |
| Enumeration Date | 2018-02-19 |
| Last Update Date | 2018-02-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
CC01699 | MN | Behavioral Health & Social Service Providers |
| Street Address |
332 W SUPERIOR ST STE 300 |
| City | DULUTH |
| State | MN |
| Zip Code | 55802-1844 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639197700 | Gregory Paul Cleary | Social Worker | 332 W Superior St Ste 300, Duluth, MN 55802-1844 | 2006-07-17 |
| 1609405240 | Luke Abraham Tervola | Counselor | 332 W Superior St Ste 300, Duluth, MN 55802-1844 | 2020-04-06 |
| 1639703242 | Krissa Ann Hultman | Counselor | 332 W Superior St Ste 300, Duluth, MN 55802-1844 | 2020-02-24 |
| 1033751003 | Paul Russell Giddings | Counselor | 332 W Superior St Ste 300, Duluth, MN 55802-1844 | 2019-10-11 |
| 1649811670 | Taylor Fellbaum | Counselor | 332 W Superior St Ste 300, Duluth, MN 55802-1844 | 2019-10-01 |
| 1790339794 | Ashley Demars | Counselor | 332 W Superior St Ste 300, Duluth, MN 55802-1844 | 2019-07-29 |
| 1295296564 | Dawn Denise Schulze | Counselor | 332 W Superior St Ste 300, Duluth, MN 55802-1844 | 2019-03-28 |
| 1154803534 | Alison Elizabeth Suominen | Counselor | 332 W Superior St Ste 300, Duluth, MN 55802-1844 | 2018-09-03 |
| 1043792435 | Nicole Ann Leland | Counselor | 332 W Superior St Ste 300, Duluth, MN 55802-1844 | 2018-08-31 |
| 1013493345 | Amy Jo Schwab | Nurse Practitioner | 332 W Superior St Ste 300, Duluth, MN 55802-1844 | 2018-07-19 |
| 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 | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730796608 | Shakeia Brodie | Counselor | 6290 Abbotts Bridge Rd Ste 304, Duluth, GA 30097-1750 | 2020-09-25 |
| 1891324588 | The Lighthouse Behavior Health Center LLC | Counselor | 4099 Buckingham Pl, Duluth, GA 30096-4271 | 2020-04-03 |
| 1861031940 | Elizabeth Ashley Edouard | Counselor | 3464 Duluth Hwy 120, Duluth, GA 30096 | 2020-01-06 |
| 1194368860 | Anine Patrice Jensen | Counselor | 101 W 2nd St Ste 101, Duluth, MN 55802-5021 | 2019-10-24 |
| 1043875164 | Individual Services | Counselor | 114 W Superior St, Duluth, MN 55802-3000 | 2019-05-03 |
| 1285107029 | Tanya Zeiliger | Counselor | 2601 Cannon Farm Ln, Duluth, GA 30097-4317 | 2019-01-04 |
| 1982187068 | Lighthouse Clinical Counseling, LLC | Counselor | 3883 Rogers Bridge Road, Suite 601, Duluth, GA 30097 | 2018-09-13 |
| 1376025643 | Faithe Beanne Kimsey | Counselor | 3883 Rogers Bridge Road Nw, Suite 601, Duluth, GA 30097 | 2018-09-04 |
| 1720572886 | Jennifer Dreibelbis Hama | Counselor | 3460 Summit Ridge Pkwy Ste 503, Duluth, GA 30096-1621 | 2018-06-21 |
| 1134664311 | Amp Group, LLC | Counselor | 331 West Superior Street, Duluth, MN 55802 | 2016-12-27 |
| 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.