NPI 1326075813 · live from the CMS NPI Registry
Brian Arthur Nystrom, L.I.C.S.W., L.M.F.T.
Social Worker, Clinical in New Brighton, MN. National Provider Identifier 1326075813, active.
NPI record
| NPI | 1326075813 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | Brighton Professional Bldg, 1900 Silver Lake Road #110, New Brighton, MN 55112 |
| Practice phone | 651-628-9566 |
| Mailing address | Brighton Professional Bldg, 1900 Silver Lake Road #110, New Brighton, NE 55112 |
| Enumerated | June 28, 2006 |
| Last updated | May 27, 2008 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker, Clinical primary | 1041C0700X | 06197 (MN) |
| Marriage & Family Therapist | 106H00000X | 0145 (MN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.