EAST CENTRAL AUDIOLOGY, LTD (NPI# 1124183314) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124183314 |
| Entity Type | Organization |
| Organization Name | EAST CENTRAL AUDIOLOGY, LTD |
| Practice Address |
1068 Lake St S Suite 108 Forest Lake MN 55025-2639 |
| Practice Telephone | 6514648486 |
| Practice Fax Number | 6514648747 |
| Mailing Telephone | 6514648486 |
| Mailing Fax Number | 6514648747 |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JULIE ANN PERREAULT (CEO) |
| Authorized Official Telephone | 6514648486 |
| Authorized Official Credential | AUDIOLOGIST |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 231H00000X | Audiologist | 6007 | MN | Speech, Language and Hearing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | HEALTHPARTNERS | 41394 | 01 |
| MN | BLUE CROSS BLUE SHIELD | 5G979EA | 01 |
| MN | UCARE | 114370 | 01 |
| MN | PERFERRED ONE | 1011302 | 01 |
| Street Address |
1068 LAKE ST S SUITE 108 |
| City | FOREST LAKE |
| State | MN |
| Zip Code | 55025-2639 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770588188 | William Howard Stackpole | Dentist | 1068 Lake St S, Ste 210, Forest Lake, MN 55025-2634 | 2005-06-14 |
| 1699238139 | Forest Lake Smiles, Pa | Clinic/Center | 1068 Lake St S, Forest Lake, MN 55025-2639 | 2019-04-11 |
| 1164811295 | Megan Mikulski | Counselor | 1068 Lake St S, Suite 12, Forest Lake, MN 55025-2639 | 2015-01-13 |
| 1588094171 | Rossodontics Dental Sleep Medicine | Dentist | 1068 Lake St S, Sutie #205, Forest Lake, MN 55025-2639 | 2013-11-18 |
| 1134412844 | Laura A D Kunde | Counselor | 1068 Lake St S, #109, Forest Lake, MN 55025-2639 | 2011-05-27 |
| 1518266162 | Adrienne M Kovar | Social Worker | 1068 Lake St S, Ste 109, Forest Lake, MN 55025-2633 | 2011-03-22 |
| 1164728176 | Julie Eschenlauer | Psychologist | 1068 Lake St S, Suite 12, Forest Lake, MN 55025-2639 | 2011-02-08 |
| 1932438777 | Timothy James Sheehan | Psychologist | 1068 Lake St S, Forest Lake, MN 55025-2639 | 2009-12-07 |
| 1932437126 | Jorja Jamison | Counselor | 1068 Lake St S, Ste 109, Forest Lake, MN 55025-2633 | 2009-11-25 |
| 1477795615 | Breanna Dee Herbst | Counselor | 1068 Lake St S, Suite 12, Forest Lake, MN 55025-2639 | 2009-04-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043846173 | Persistence Physical Therapy LLC | Clinic/Center | 2009 W Broadway Ave, Ste 400 Pmb 131, Forest Lake, MN 55025 | 2020-03-20 |
| 1255973319 | Connie Rettig | Technician | 908 North Shore Drive, Forest Lake, MN 55025 | 2019-10-10 |
| 1003394479 | Malissa Ann Costanzo | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 844 8th Ave Se, Forest Lake, MN 55025 | 2018-07-30 |
| 1669754735 | Brent Alan Millard | Pharmacist | 1207 West Broadway Ave, Forest Lake, MN 55025 | 2011-09-15 |
| 1982842167 | Lakes Center for Youth and Families | Community/Behavioral Health | 20 N Lake Street, Suite 103, Forest Lake, MN 55025 | 2009-01-27 |
| 1487843355 | Paul Luke Mladnick | Marriage & Family Therapist | 1068 So Lake St, #109, Forest Lake, MN 55025 | 2007-10-17 |
| 1740477678 | Rita Lynn Scanlan | Occupational Therapist | 604 Ne 1st St, Birchwood Health Care Center, Forest Lake, MN 55025 | 2007-09-25 |
| 1114053113 | Senior Care Forest Lake, LLC | Skilled Nursing Facility | 604 N.e. First Street, Forest Lake, MN 55025 | 2007-02-26 |
| 1073672101 | Catharine B Ruther | Dentist | 956 West Broadway, Lakes Dental Clinic, Forest Lake, MN 55025 | 2006-12-06 |
| 1407914849 | Ervin George Savord | Dentist | 255 Highway 97, Suite 1b, Forest Lake, MN 55025 | 2006-12-05 |
| Find all providers in zip 55025 | ||||
| Taxonomy Code | 231H00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Audiologist |
| (1) A specialist in evaluation, habilitation and rehabilitation of those whose communication disorders center in whole or in part in hearing function. Audiologists are autonomous professionals who identify, assess, and manage disorders of the auditory, balance and other neural systems. Audiologists provide audiological (aural) rehabilitation to children and adults across the entire age span. Audiologists select, fit and dispense amplification systems such as hearing aids and related devices. (2) An audiologist is a person qualified by a master’s degree in audiology, licensed by the state, where applicable, and practicing within the scope of that license. Audiologists evaluate and treat patients with impaired hearing. They plan, direct and conduct rehabilitative programs with audiotry substitutional devises (hearing aids) and other therapy. |
| Notes: Source: (1) American Speech-Language-Hearing Association, (1996, Spring) Scope of practice in Audiology, p. 2 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528336161 | Belinda D Mccurry | Audiologist | 1068 Lake St S Ste 108, Forest Lake, MN 55025-2633 | 2011-12-10 |
| 1760569727 | Julie Ann Perreault | Audiologist | 1068 S Lake Street, Suite 108, Forest Lake, MN 55025 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043839715 | Thomas J Tedeschi | Audiologist | 150 S 5th St Ste 2300, Minneapolis, MN 55402-4223 | 2020-04-13 |
| 1902435514 | Robert Lang | Audiologist | 1597 Park Ave, White Bear Lake, MN 55110-3704 | 2020-04-06 |
| 1528625290 | Kara Rae Balken | Audiologist | 7300 France Ave S Ste 101, Edina, MN 55435-4525 | 2019-05-28 |
| 1538724612 | Elizabeth Mary Butler | Audiologist | 1155 E County Road E, Ste 100, Minneapolis, MN 55110-5191 | 2019-05-05 |
| 1417422445 | Joelle Peterson | Audiologist | 12925 16th Ave N, Plymouth, MN 55441-4560 | 2018-10-05 |
| 1275028227 | Karen Brennhofer | Audiologist | 2200 Nw 26th St Apt 309, Owatonna, MN 55060 | 2018-06-22 |
| 1700313681 | Hannah Catherine Erickson Herd | Audiologist | 701 25th Ave S Fl 2, Minneapolis, MN 55454 | 2017-05-22 |
| 1245780121 | Rachel Lauren Marston | Audiologist | 7745 2nd Ave S., Suite 1, Richfield, MN 55423 | 2016-10-04 |
| 1184178956 | Eric R Barrett | Audiologist | Starkey Center for Excellence, 6700 Washington Ave S, Eden Prairie, MN 55344 | 2016-08-10 |
| 1457711327 | Reynolds Audiology LLC | Audiologist | 2155 Woodlane Drive, Suite 103, Woodbury, MN 55125-3049 | 2016-03-04 |
| Find all providers with the same taxonomy | ||||
| City | FOREST LAKE |
| Zip Code | 55025 |
Please comment or provide details below to improve the information on EAST CENTRAL AUDIOLOGY, LTD.
| 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.