NORTHEAST HUMAN SERVICE CENTER (NPI# 1366496341) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366496341 |
| Entity Type | Organization |
| Organization Name | NORTHEAST HUMAN SERVICE CENTER |
| Practice Address |
151 S 4th St Suite 401 Grand Forks ND 58201-4715 |
| Practice Telephone | 7017953000 |
| Practice Fax Number | 7017953050 |
| Mailing Telephone | 7017953000 |
| Mailing Fax Number | 7017953050 |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. KATHRYN M. KENNA (DIRECTOR) |
| Authorized Official Telephone | 7017953014 |
| Authorized Official Credential | MSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| X | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| X | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| X | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
1049 | ND | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 054519 | 05 | |
| ND | RAILROAD MEDICARE # | CI4039 | 01 |
| ND | BCBS OF MN PROV # | 90963NO | 01 |
| ND | BCBS ND PROV # | 242001 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891808978 | Northeast Human Service Center | Residential Treatment Facility, Emotionally Disturbed Children | 151 S 4th St Ste 401, Grand Forks, ND 58201-4715 | 2006-08-16 |
| 1922529932 | Northeast Human Service Center | Community/Behavioral Health | 151 S 4th St Ste 401, Grand Forks, ND 58201-4715 | 2017-06-29 |
| 1689612475 | Northeast Human Service Center | Clinic/Center | 151 S 4th St, Suite 401, Grand Forks, ND 58201-4715 | 2006-06-03 |
| Street Address |
151 S 4TH ST SUITE 401 |
| City | GRAND FORKS |
| State | ND |
| Zip Code | 58201-4715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336752443 | Garett C Wiltse | Counselor | 151 S 4th St, Grand Forks, ND 58201-4715 | 2020-08-28 |
| 1700496775 | Caylee Ellingson | Psychologist | 151 S 4th St, Grand Forks, ND 58201-4715 | 2020-08-05 |
| 1134647530 | Cynthia Severinson | Registered Nurse | 151 S 4th St, Ste 401, Grand Forks, ND 58201 | 2017-09-06 |
| 1194255026 | George C. Jirout | Social Worker | 151 S 4th St, Grand Forks, ND 58201-4715 | 2017-06-13 |
| 1568998391 | Casey Davidson | Social Worker | 151 S 4th St, Suite 201, Grand Forks, ND 58201-4715 | 2017-05-11 |
| 1043745763 | Michelle Marie Tupa | Social Worker | 151 S 4th St, Suite 401, Grand Forks, ND 58201-4715 | 2017-05-01 |
| 1740713239 | Sara Bondy | Social Worker | 151 S 4th St, Suite 401, Grand Forks, ND 58201-4715 | 2017-04-11 |
| 1184157349 | Erin West | Counselor | 151 S 4th St, Suite 401, Grand Forks, ND 58201-4715 | 2017-04-05 |
| 1215471362 | Sara K. Munson | Counselor | 151 S 4th St, Suite 401, Grand Forks, ND 58201-4715 | 2016-12-08 |
| 1568918001 | Shosti L. Aaker | Counselor | 151 S 4th St, Suite 401, Grand Forks, ND 58201-4715 | 2016-08-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255965398 | Development Homes Inc | Intermediate Care Facility, Mentally Retarded | 5509 Cottonwood Street, Grand Forks, ND 58201 | 2020-02-27 |
| 1932753779 | Lydia Pansegrau | Occupational Therapist | 2950 36th Ave S, Apt A-11, Grand Forks, ND 58201 | 2019-07-30 |
| 1407416019 | Kristina Aikens | Optometrist | 1820 S 42nd St, Grand Forks, ND 58201 | 2019-06-17 |
| 1861963209 | Jessica Kovsky | Occupational Therapist | 1375 S Columbia Rd- Altru Performance Center, Grand Forks, ND 58201 | 2018-12-11 |
| 1609345834 | Altru Specialty Services, Inc | Durable Medical Equipment & Medical Supplies | 1375 South Columbia Road, Suite A, Grand Forks, ND 58201 | 2018-11-16 |
| 1225523004 | Alicia Mae Mack | Registered Nurse | 212 S. 4th St. Suite 301, Spectra Health, Grand Forks, ND 58201 | 2018-06-25 |
| 1396260808 | Amber White | Behavior Technician | 2016 S Washington St., Grand Forks, ND 58201 | 2017-08-04 |
| 1225579840 | Kathleen Suzanne Tillman | Psychologist | 2100 S Columbia Road, Suite 202, Family Institute, PC, Grand Forks, ND 58201 | 2017-03-15 |
| 1881148906 | Melissa Pytlik Monson | Physician Assistant | 1380 S Columbia Rd - Altru Family Medcine Center, Grand Forks, ND 58201 | 2016-08-05 |
| 1477936029 | Laura Jane Carlson | Nurse Practitioner | 3165 Demers Avenue - Truyu Aesthetic Center, Grand Forks, ND 58201 | 2015-07-01 |
| Find all providers in zip 58201 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265658967 | Center for Self-growth & Renewal, PC | Clinic/Center | 1551 28th Ave S, Suite C, Grand Forks, ND 58201-6782 | 2007-04-18 |
| 1902325319 | Roller Psychology, Pllc | Clinic/Center | 3301 30th Ave S Ste 101, Grand Forks, ND 58201-6009 | 2017-09-18 |
| 1346781747 | Community Violence Intervention Center | Clinic/Center | 211 S 4th St, Grand Forks, ND 58201-4737 | 2017-03-17 |
| 1740683242 | Insight Forensic Psychology LLC | Clinic/Center | 12 S 3rd St, Suite 203, Grand Forks, ND 58201-4798 | 2014-09-29 |
| 1275789273 | Hull Consultants, Inc. | Clinic/Center | 1407 24th Ave S, Suite 206, Grand Forks, ND 58201-6761 | 2008-08-11 |
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|---|---|---|---|---|
| 1922626456 | Tess R Johnson, Pllc | Clinic/Center | 579 River Drive, Dickinson, ND 58601 | 2020-07-10 |
| 1609492016 | Igniting Your Change | Clinic/Center | 1222 4th Ave N Apt 318, Fargo, ND 58102-4374 | 2020-06-22 |
| 1922636323 | Peace of Mind Counseling, Pllc | Clinic/Center | 8351 Palomino Dr, Bismarck, ND 58504-4044 | 2020-03-31 |
| 1093295859 | Healing Hearts Therapy, LLC | Clinic/Center | 511 2nd St W, Williston, ND 58801-5907 | 2018-08-20 |
| 1801337415 | Selah Counseling | Clinic/Center | 125 Main St, Suite #220, Williston, ND 58801 | 2017-03-15 |
| 1225414956 | 30:17 Counseling | Clinic/Center | 1751 Main Ave E, West Fargo, ND 58078-2203 | 2015-08-04 |
| 1043451370 | Sacajawea Substance Abuse Counseling and Drug Testing Center | Clinic/Center | 112 3rd Street West, Suite 301, Dickinson, ND 58601 | 2009-03-17 |
| 1205932233 | Heart River Alcohol and Drug Abuse Services Inc. | Clinic/Center | 24 W Villard St Ste B, Dickinson, ND 58601-5152 | 2006-09-16 |
| 1588694392 | The Village Family Service Centere | Clinic/Center | 20 1st St Sw, Minot, ND 58701-3851 | 2006-07-04 |
| 1770524613 | Northwest Human Service Center | Clinic/Center | 316 2nd Ave W, Williston, ND 58801-5218 | 2006-06-10 |
| Find all providers with the same taxonomy | ||||
| City | GRAND FORKS |
| Zip Code | 58201 |
Please comment or provide details below to improve the information on NORTHEAST HUMAN SERVICE CENTER.
| 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.