NORTHWESTERN MENTAL HEALTH CENTER (NPI# 1508835133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1508835133 |
Entity Type | Organization |
Organization Name | NORTHWESTERN MENTAL HEALTH CENTER |
Practice Address |
603 Bruce St Crookston MN 56716 |
Mailing Address |
603 Bruce Street Po Box 603 Crookston MN 56716-0603 |
Practice Telephone | 2182813940 |
Practice Fax Number | 2182816261 |
Mailing Telephone | 2182813940 |
Mailing Fax Number | 2182816261 |
Enumeration Date | 2006-03-16 |
Last Update Date | 2018-06-25 |
Authorized Official Name | MS. SHAUNA R REITMEIER (CHIEF EXECUTIVE OFFICER) |
Authorized Official Telephone | 2182813940 |
Authorized Official Credential | LGSW |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
8017741MHC | MN | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MN | 054855300 | 05 | |
RAILROAD MEDICARE | CC6573 | 01 | |
MN | UCARE MINNESOTA | 116586 | 01 |
UBH MEDICA | 1520165 | 01 | |
HEALTH PARTNERS | 31167 | 01 | |
MN | BCBS BHSI | 63592NO | 01 |
PREFERRED ONE | 93272 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225337355 | Northwestern Mental Health Center | Community/Behavioral Health | 603 Bruce St, Crookston, MN 56716-2914 | 2011-03-15 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | NORTHWESTERN MENTAL HEALTH CENTER INC | 603 Bruce St, Crookston, MN 56716-2914 |
Street Address |
603 BRUCE ST |
City | CROOKSTON |
State | MN |
Zip Code | 56716 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538787841 | Justine Danielle John | Social Worker | 603 Bruce St, Crookston, MN 56716-2914 | 2020-07-13 |
1891341319 | Elizabeth Ann Murphy | Nurse Practitioner | 603 Bruce St, Crookston, MN 56716-2914 | 2019-08-12 |
1902369275 | Janelle Bernice Artmann | Social Worker | 603 Bruce St, Crookston, MN 56716-2914 | 2019-04-12 |
1770047367 | Mandy Leeann Lundby | Social Worker | 603 Bruce St, Crookston, MN 56716-2914 | 2019-01-28 |
1184191066 | Valerie Wagner | Counselor | 603 Bruce St, Crookston, MN 56716-2914 | 2018-10-29 |
1245711720 | Lindsey Young | Counselor | 603 Bruce St, Crookston, MN 56716-2914 | 2018-08-23 |
1912483397 | Amber Dawn Deere | Nurse Practitioner | 603 Bruce St, Crookston, MN 56716-2914 | 2018-07-18 |
1336664614 | Matthew Ryan Keller | Social Worker | 603 Bruce St, Crookston, MN 56716-2914 | 2017-08-08 |
1265953053 | Martina Mlikota | Counselor | 603 Bruce St, Crookston, MN 56716-2914 | 2017-06-30 |
1821533035 | Lauren Shalane Wagendorf | Counselor | 603 Bruce St, Crookston, MN 56716 | 2016-12-23 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942789912 | Savannah Danielle Miller | Pharmacist | 323 S Minnesota Street, Crookston, MN 56716 | 2018-08-10 |
1902037377 | David Fernando Frugone Larrea | Internal Medicine | 400 South Minnesota Street, Crookston, MN 56716 | 2009-08-04 |
1831327964 | Andres O Makarem | Internal Medicine | 400 S. Minnesota Ave, Crookston, MN 56716 | 2009-06-26 |
1255498564 | Ind School District 593 | Local Education Agency (LEA) | 402 Fisher Ave, Crookston, MN 56716 | 2007-01-03 |
1821109422 | Marla Rae Love | Dietitian, Registered | 400 S Minnesota Street, Crookston, MN 56716 | 2006-08-31 |
1215932728 | Villa St. Vincent | Skilled Nursing Facility | 516 Walsh St, Crookston, MN 56716 | 2005-06-21 |
1740769090 | Christine Jane Loff | Physical Therapist | 323 S Minnesota St, Crookston, MN 56716 | 2018-08-08 |
1336594449 | Lesmeister Dental LLC | Dentist | 1726 University Ave, Crookston, MN 56716 | 2016-04-26 |
1700271012 | Maneesh C. Kanal | Internal Medicine | 323 S Minnesota St, Crookston, MN 56716 | 2015-04-02 |
1114270550 | William T Erickson | Dentist | 1726 University Ave, Crookston, MN 56716 | 2012-10-23 |
Find all providers in zip 56716 |
Taxonomy Code | 261QM0801X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Mental Health (Including Community Mental Health Center) |
Definition to come... |
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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.