THOMAS EDWARD KLECKER (NPI# 1497936926) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497936926 |
| Entity Type | Individual |
| Full Name | THOMAS EDWARD KLECKER |
| Credential | LICSW LP |
| Practice Address |
1906 5th Ave Se Little Falls MN 56345-0367 |
| Mailing Address |
Po Box 367 Northern Pines Mental Health Center Little Falls MN 56345-0367 |
| Practice Telephone | 3206326647 |
| Practice Fax Number | 3206329525 |
| Mailing Telephone | 3206326647 |
| Mailing Fax Number | 3206329525 |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2007-11-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
1802 | MN | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
LICSW2045 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | MEDICA | 6268607 | 01 |
| MN | BLUE CROSS | 69658KL | 01 |
| Street Address |
1906 5TH AVE SE |
| City | LITTLE FALLS |
| State | MN |
| Zip Code | 56345-0367 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013904051 | Northern Pines Mental Health Center, Inc. | Clinic/Center | 1906 5th Ave Se, Little Falls, MN 56345-3317 | 2005-10-04 |
| 1912475310 | Stacy Lynn Burrell | Counselor | 1906 5th Ave Se, Little Falls, MN 56345-3317 | 2018-11-05 |
| 1104336312 | Brittney Jelinski | Counselor | 1906 5th Ave Se, Little Falls, MN 56345-3317 | 2017-10-03 |
| 1417484015 | Karen Hutchins | Counselor | 1906 5th Ave Se, Little Falls, MN 56345-3317 | 2017-05-15 |
| 1609315357 | Elisabeth Ruby | Marriage & Family Therapist | 1906 5th Ave Se, Little Falls, MN 56345-3317 | 2017-02-14 |
| 1427416106 | Roy John Neumann | Counselor | 1906 5th Ave Se, Little Falls, MN 56345-3317 | 2016-02-09 |
| 1730527367 | Roxann J Storms | Social Worker | 1906 5th Ave Se, Little Falls, MN 56345-3317 | 2013-06-05 |
| 1154601243 | Terry Riley | Marriage & Family Therapist | 1906 5th Ave Se, Little Falls, MN 56345-3317 | 2011-08-22 |
| 1932493384 | Therese Rose Meyer | Marriage & Family Therapist | 1906 5th Ave Se, Little Falls, MN 56345-3317 | 2011-06-02 |
| 1235351917 | Patricia Lee Gorman | Counselor | 1906 5th Ave Se, Little Falls, MN 56345-3317 | 2007-05-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255823910 | Apple Tree Dental | Dentist | 808 3rd St Se Ste 330, Little Falls, MN 56345 | 2018-05-30 |
| 1326548454 | Julie Bonham | Dental Therapist | 803 3rd St. Se, Suite 330, Little Falls, MN 56345 | 2018-02-15 |
| 1386079846 | Paul Carpenter | Physical Therapist | 104 2nd St Se, Little Falls, MN 56345 | 2013-09-03 |
| 1114282670 | Annalee Michelle Vandenheuvel | Social Worker | 1905 5th Ave Se, Little Falls, MN 56345 | 2012-07-11 |
| 1962761601 | Heather Van Stone | Audiologist | 109 5th St Ne Ste 2, Little Falls, MN 56345 | 2012-05-15 |
| 1003055989 | Brett Wayne Speer | Chiropractor | 114 1st Street Ne, Little Falls, MN 56345 | 2009-02-17 |
| 1104007988 | Sharon Anne Bell | Physical Therapist | 309 First St. Ne, Suite 101, Little Falls, MN 56345 | 2007-11-20 |
| 1215072996 | Robert Willhite | Pharmacist | 101 1st St Ne, Little Falls, MN 56345 | 2007-02-21 |
| 1568526275 | Jeffrey Hoffman | Physical Therapist | 815 Se 2nd Street, Unity Family Healthcare, Little Falls, MN 56345 | 2006-12-20 |
| 1700978020 | Jennifer Mary Hagen | Pharmacist | 101 1st St Se, Little Falls, MN 56345 | 2006-09-28 |
| Find all providers in zip 56345 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
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| 1134732514 | Colleen Cashen | Psychologist | 1341 Cleveland Ave S, Saint Paul, MN 55116-2653 | 2020-08-26 |
| 1295357440 | Pure Potential Counseling | Psychologist | 18685 Dylan Dr, Farmington, MN 55024-7070 | 2020-05-11 |
| 1871115337 | Melissa Jean King | Psychologist | 205 W 2nd St Ste 437, Duluth, MN 55802-1922 | 2020-05-07 |
| 1841811296 | Kristen Math X | Psychologist | 1603 Pebble Creek Dr, Sartell, MN 56377-4538 | 2020-04-27 |
| 1245859982 | Thomas Allen | Psychologist | 12 Valley View Pl, Mankato, MN 56001-2500 | 2020-04-13 |
| 1033749163 | Neurocalm, LLC | Psychologist | 3153 Hennepin Ave Ste 211, Minneapolis, MN 55408-2620 | 2020-01-16 |
| 1457999500 | Megan Robb | Psychologist | 555 W Broadway Ave Ste 2and3, Forest Lake, MN 55025-1175 | 2019-12-18 |
| 1821635723 | Leadership Coaching Institute LLC | Psychologist | 1264 Garden St, Ogilvie, MN 56358-3520 | 2019-12-10 |
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| City | LITTLE FALLS |
| Zip Code | 56345 |
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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.