NORTHERN LAKES CLINIC, INC. (NPI# 1114071420) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114071420 |
| Entity Type | Organization |
| Organization Name | NORTHERN LAKES CLINIC, INC. |
| Other Organization Name | NORTHERN LAKES CLINIC |
| Practice Address |
301 America Ave Nw Bemidji MN 56601-3120 |
| Mailing Address |
6200 Excelsior Blvd Suite 202 St Louis Park MN 55416-2730 |
| Practice Telephone | 2187555170 |
| Practice Fax Number | 2187511194 |
| Mailing Telephone | 9529255344 |
| Mailing Fax Number | 9525489350 |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. LOIS COCHRANE SCHLUTTER (CEO & OWNER) |
| Authorized Official Telephone | 9529255344 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
1045771-1-CDT | MN | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Northern Lakes Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750435459 | Northern Lakes Clinic, Inc. | Clinic/Center | 301 America Ave Nw, Bemidji, MN 56601-3120 | 2007-01-22 |
| Street Address |
301 AMERICA AVE NW |
| City | BEMIDJI |
| State | MN |
| Zip Code | 56601-3120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750435459 | Northern Lakes Clinic, Inc. | Clinic/Center | 301 America Ave Nw, Bemidji, MN 56601-3120 | 2007-01-22 |
| 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 | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689874562 | Lakes Region Chemical Dependency LLC | Clinic/Center | 1510 Bemidji Ave N Ste 13, Bemidji, MN 56601-3804 | 2007-07-19 |
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| 1881250785 | Adap Consulting | Clinic/Center | 1605 Southcross Dr W Ste B, Burnsville, MN 55306-7013 | 2019-05-15 |
| 1821550005 | Coscarelli Consulting, LLC | Clinic/Center | 1687 Woodlane Dr Ste 2002, Woodbury, MN 55125-3063 | 2019-04-04 |
| 1669943908 | Capital Health Services LLC | Clinic/Center | 680 Mendelssohn Ave N, Golden Valley, MN 55427-4306 | 2018-12-16 |
| 1013497916 | Thrive Behavioral Network Iv, LLC | Clinic/Center | 119 Friberg Ave, Suite B, Fergus Falls, MN 56537-2251 | 2018-08-20 |
| 1780186130 | Alliance Wellness Clinic Inc. | Clinic/Center | 8040 Old Cedar Ave. S. Ste. 100, Bloomington, MN 55425-1211 | 2018-03-01 |
| 1447795596 | Conceptual Counseling & Assessment | Clinic/Center | 151 W Burnsville Pkwy Ste 101, Burnsville, MN 55337-2525 | 2016-12-28 |
| 1871035568 | No Other Way (now) Recovery Services LLC | Clinic/Center | 1614 W 3rd St, Red Wing, MN 55066-2086 | 2016-11-11 |
| 1104374073 | Lakes Opioid Treatment Program, Inc | Clinic/Center | 8381 Lake Land Trl Nw, Walker, MN 56484-2109 | 2016-09-20 |
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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.