INDIGENOUS CIRCLES COUNSELING CENTER (NPI# 1720580814) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720580814 |
| Entity Type | Organization |
| Organization Name | INDIGENOUS CIRCLES COUNSELING CENTER |
| Practice Address |
12000 Elm Creek Blvd N Ste L70 Maple Grove MN 55369-7167 |
| Mailing Address |
Po Box 18655 Minneapolis MN 55418-0655 |
| Practice Telephone | 6129107194 |
| Mailing Telephone | 6129107194 |
| Enumeration Date | 2018-03-05 |
| Last Update Date | 2018-03-05 |
| Authorized Official Name | FELIX RAYMOND MONTEZ (CEO) |
| Authorized Official Telephone | 6129107194 |
| Authorized Official Credential | LPCC, LADC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| Street Address |
12000 ELM CREEK BLVD N STE L70 |
| City | MAPLE GROVE |
| State | MN |
| Zip Code | 55369-7167 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720110737 | John William Petersen | Chiropractor | 12000 Elm Creek Blvd N Ste L70, Maple Grove, MN 55369-7167 | 2007-03-12 |
| 1285100263 | Lynn Renee Borgmann | Counselor | 12000 Elm Creek Blvd N Ste L70, Maple Grove, MN 55369-7167 | 2018-10-17 |
| 1346590627 | Sheanne Scherber | Counselor | 12000 Elm Creek Blvd N Ste L70, Maple Grove, MN 55369-7167 | 2012-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144188 | Bonnie Rose Theis | Counselor | 24 3rd Ave Ne, Unit B, Osseo, MN 55369 | 2020-11-06 |
| 1356976328 | Kirollos Samir Hanna | Pharmacist | 14500 99th Ave N, Suite 0a030, Maple Grove, MN 55369 | 2020-03-10 |
| 1396395463 | Susan Osborne | Technician | 9240 Orchid Lane, Maple Grove, MN 55369 | 2019-09-19 |
| 1710537196 | Janis Langsdale | Technician | 11070 108 Avenue North, Maple Grove, MN 55369 | 2019-09-17 |
| 1043724552 | Tracey Wahlquist | Speech-Language Pathologist | 11100 86th Ave N, Maple Grove, MN 55369 | 2017-11-20 |
| 1154860005 | Kayla Uptagrafft | Specialist/Technologist | 9555 Upland Lane Norh, Maple Grove, MN 55369 | 2017-02-13 |
| 1750823324 | Jennifer Ranallo | Social Worker | 9600 Upland Ln N Ste 110, Maple Grove, MN 55369 | 2016-11-13 |
| 1558723999 | Debra Grace Boersma | Advanced Practice Midwife | 9825 Hospital Dr#205, Maple Grove, MN 55369 | 2016-03-24 |
| 1396129433 | Maple Grove Smiles Dentistry, PC | Dentist | 12775 Elm Creek Blvd N, Maple Grove, MN 55369 | 2015-07-18 |
| 1558755900 | Krista Newman | Counselor | 24 3rd St Nw, Unit B, Osseo, MN 55369 | 2015-03-24 |
| Find all providers in zip 55369 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124370986 | Brent Richter Consulting, LLC | Clinic/Center | 7218 Forestview Ln N Ste 107, Maple Grove, MN 55369-5644 | 2012-10-03 |
| 1114547809 | Maternal Wellness Counseling Pllc | Clinic/Center | 6493 Sycamore Ct N, Maple Grove, MN 55369-6028 | 2020-04-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174123376 | Como Behavioral Care LLC | Clinic/Center | 441 Old Highway 8 Nw Ste 213, New Brighton, MN 55112-3235 | 2020-10-27 |
| 1962000646 | Life Care Health Services LLC | Clinic/Center | 1808 Riverside Ave Ste 211, Minneapolis, MN 55454-1121 | 2020-10-14 |
| 1639788755 | Cazares Professional Therapy | Clinic/Center | 166 Farrington St, Saint Paul, MN 55102-2104 | 2020-07-24 |
| 1770100877 | Halabrin Marty and Associates | Clinic/Center | 12760 Aberdeen St Ne Ste 2122760, Blaine, MN 55449-5845 | 2020-07-06 |
| 1891312732 | Healthy Balance Psychology, LLC | Clinic/Center | 1550 Sunset Dr Sw, Owatonna, MN 55060-3854 | 2020-06-26 |
| 1134745300 | Quality Care Counseling Services LLC | Clinic/Center | 4141 Central Ave Ne Ste 250, Columbia Heights, MN 55421-3611 | 2020-06-23 |
| 1780207829 | Amazing You Therapy, LLC | Clinic/Center | 421 1st Ave Sw Ste 300w, Rochester, MN 55902-3389 | 2020-05-23 |
| 1609499813 | Bright Place LLC | Clinic/Center | 3835 Bakken Blvd, Columbia Heights, MN 55421-5056 | 2020-05-21 |
| 1568082428 | Cloud Home Health Care Services LLC | Clinic/Center | 22 Wilson Ave Ne Ste 208, Saint Cloud, MN 56304-0440 | 2020-04-21 |
| 1235763814 | Monarch Wellness LLC | Clinic/Center | 51 E 4th St Ste 309, Winona, MN 55987-3791 | 2020-02-23 |
| Find all providers with the same taxonomy | ||||
| City | MAPLE GROVE |
| Zip Code | 55369 |
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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.