NORTHERN PINES MENTAL HEALTH CENTER, INC (NPI# 1134261290) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134261290 |
| Entity Type | Organization |
| Organization Name | NORTHERN PINES MENTAL HEALTH CENTER, INC |
| Practice Address |
520 Nw 5th St Brainerd MN 56401-2902 |
| Mailing Address |
407 N 4th St Brainerd MN 56401-3034 |
| Practice Telephone | 2188293235 |
| Practice Fax Number | 2188291368 |
| Mailing Telephone | 2188293235 |
| Mailing Fax Number | 2188291368 |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. MARK FRANCIS BUBLITZ (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2188293235 |
| Authorized Official Credential | LICSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 05401 | MN | Agencies |
| Street Address |
520 NW 5TH ST |
| City | BRAINERD |
| State | MN |
| Zip Code | 56401-2902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205305406 | Susan Lee Schwankl | Counselor | 520 Nw 5th St, Brainerd, MN 56401-2902 | 2018-11-16 |
| 1720563919 | William Lee Wilson Jr. | Social Worker | 520 Nw 5th St, Brainerd, MN 56401-2902 | 2018-10-03 |
| 1962988774 | Rebecca Gonzalez | Nurse Practitioner | 520 Nw 5th St, Brainerd, MN 56401-2902 | 2018-07-15 |
| 1790138550 | Katy Jean Srock | Clinical Nurse Specialist | 520 Nw 5th St, Brainerd, MN 56401-2902 | 2016-07-18 |
| 1558717371 | Michelle Kimman | Marriage & Family Therapist | 520 Nw 5th St, Brainerd, MN 56401-2902 | 2016-05-11 |
| 1689020752 | Megan Kay Mueller | Marriage & Family Therapist | 520 Nw 5th St, Brainerd, MN 56401-2902 | 2016-05-09 |
| 1881051621 | Miranda Kay Skinner | Counselor | 520 Nw 5th St, Brainerd, MN 56401 | 2016-01-25 |
| 1639517238 | Jean Kocer | Social Worker | 520 Nw 5th St, Brainerd, MN 56401-2902 | 2013-06-05 |
| 1649547589 | Mary Darlene Millicent | Counselor | 520 Nw 5th St, Brainerd, MN 56401-2902 | 2011-11-21 |
| 1154619823 | Tamara Rose Kmecik | Social Worker | 520 Nw 5th St, Brainerd, MN 56401-2902 | 2011-07-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396222832 | Nicholas James Manning | Physical Therapist | 7350 Clearwater Rd N, Baxter, MN 56401 | 2018-07-27 |
| 1952819757 | Hannah Marie Darabi | Physical Therapist | Essentia Health Rehabilitation Services, 2016 South Sixth Street, Brainer, MN 56401 | 2018-01-15 |
| 1154867406 | Nancy Ann Schauer | Social Worker | 823 Maple Street, Northern Pine Mental Health Center, Brainerd, MN 56401 | 2017-01-10 |
| 1336530310 | Audrey Jean Twit | Pharmacist | 523 North Third Street, Essentia Health St Joseph's Medical Center, Brainerd, MN 56401 | 2015-02-11 |
| 1245638584 | The Renneke Chiropractic Clinic | Physical Therapist | 623 Madison St., Brainerd, MN 56401 | 2014-12-19 |
| 1124420179 | Jenna Niggeler | Acupuncturist | 1001 Kingwood St Ste 119a, Brainerd, MN 56401 | 2014-09-22 |
| 1073933719 | Nicholas Adam Lesmeister | Orthopaedic Surgery | 2014 South 6th Street, Brainerd, MN 56401 | 2014-04-21 |
| 1073864666 | Jennifer L. Owens | Marriage & Family Therapist | 4706 Wilderness Ct Ste 101, Brainerd, MN 56401 | 2012-09-24 |
| 1619297447 | Christine Elaine Smalling | Licensed Practical Nurse | 6317 Estate Circle Drive, Brainerd, MN 56401 | 2010-06-03 |
| 1528241577 | Dannia Lor Vang | Pharmacist | 2024 South 6th St, Clinic Pharmacy, Brainerd, MN 56401 | 2007-12-13 |
| Find all providers in zip 56401 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245396076 | Oakridge Support Services, Inc | Community/Behavioral Health | 1021 Industrial Park Rd Sw, Brainerd, MN 56401-8338 | 2006-12-28 |
| 1659905040 | Golden Heart Home Health Services LLC | Community/Behavioral Health | 601 Madison St, Brainerd, MN 56401-4518 | 2020-02-25 |
| 1922584879 | Carlyn Becker Therapy Services | Community/Behavioral Health | 4706 Wilderness Ct Ste 101, Brainerd, MN 56401-2887 | 2018-07-13 |
| 1982064689 | Jennifer Owens Therapy Services, LLC | Community/Behavioral Health | 4706 Wilderness Ct Ste 101, Brainerd, MN 56401 | 2016-02-24 |
| 1225168602 | Northern Pines Mental Health Center, Inc. | Community/Behavioral Health | 520 Nw 5th St, Brainerd, MN 56401-2902 | 2007-03-06 |
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|---|---|---|---|---|
| 1154922102 | Alliance Development Center LLC | Community/Behavioral Health | 1545 E Lake St Ste 210, Minneapolis, MN 55407-1742 | 2020-11-05 |
| 1083212419 | Stepping Stone Counseling, LLC | Community/Behavioral Health | 339 9th St Ste C, Windom, MN 56101-1694 | 2020-10-16 |
| 1114526548 | Essential Grace Therapy, Pllc | Community/Behavioral Health | 12390 Sherburne Ave Ste 210, Becker, MN 55308-9147 | 2020-10-16 |
| 1770180606 | Anishinaabe Endaad LLC | Community/Behavioral Health | 3027 Queen Ave N, Minneapolis, MN 55411-1060 | 2020-10-05 |
| 1427662543 | Autism Center for Education LLC | Community/Behavioral Health | 2021 E Hennepin Ave Ste 187, Minneapolis, MN 55413-2187 | 2020-09-04 |
| 1235743634 | Amolo House | Community/Behavioral Health | 3730 Fremont Ave N, Minneapolis, MN 55412-2014 | 2020-09-02 |
| 1508470956 | Our Future Inc. | Community/Behavioral Health | 3055 Old Highway 8 Ste 230, St Anthony, MN 55418-2500 | 2020-09-02 |
| 1114539434 | Northway Academy, Inc. | Community/Behavioral Health | 19437 Evans Street Nw, Elk River, MN 55330-1074 | 2020-08-18 |
| 1336750769 | Community Care Partners | Community/Behavioral Health | 2817 Anthony Ln S Ste 312, St Anthony, MN 55418-2886 | 2020-08-10 |
| 1356951255 | Great Lake Care LLC | Community/Behavioral Health | 1710 Douglas Dr N Ste 224e, Golden Valley, MN 55422-4350 | 2020-08-05 |
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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.