RILEY ENGSTROM MA, LPCC, LADC
NPI 1114872223
Counselor - Professional in Shoreview, MN

Q: What is Riley Engstrom's NPI number?

The NPI number for Riley Engstrom is 1114872223. It was assigned to this individual provider in the NPPES registry on March 3, 2026.

Q: What is Riley Engstrom's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Riley Engstrom was last updated on March 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 03, 2026PECOS Enrolled

4570 CHURCHILL ST STE 300, SHOREVIEW, MN 55126(651) 313-8080 Get Directions Write a Review

NPPES record last updated: March 11, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 11, 2026, Mar 3, 2026 (2 updates tracked since 2026).

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About Riley Engstrom Ma, Lpcc, Ladc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RILEY ENGSTROM MA, LPCC, LADC (NPI 1114872223) is an individual professional provider in Shoreview, Minnesota, licensed in Minnesota (5480) and active in the NPI registry since March 2026. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1114872223

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameRILEY ENGSTROMCredential: MA, LPCC, LADC

Location Address4570 CHURCHILL ST STE 300Shoreview, MN 55126-2274

Mailing Address1900 Silver Lake Rd Nw Ste 110New Brighton, MN 55112-1789 · (651) 628-9566 · Fax (651) 628-0411

Phone(651) 313-8080

Sole ProprietorYes

Medical School CMSOtherGraduated 2023

Enumeration DateMarch 3, 2026

Last NPPES UpdateMarch 11, 20262 updates tracked since enumeration

NPPES CertifiedMarch 11, 2026

✔ NPI 1114872223 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in MN · 5480

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 306669 (MN)

4570 CHURCHILL ST STE 300, Shoreview, MN 55126

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Riley Engstrom Ma, Lpcc, Ladc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6608350160

PECOS Enrollment IDI20260323002262

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROGER LEE BURTRAW III PT

Physical Therapist