J M BALDUS, INC (NPI# 1730520172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730520172 |
| Entity Type | Organization |
| Organization Name | J M BALDUS, INC |
| Practice Address |
5200 Maywood Rd Mound MN 55364-1775 |
| Mailing Address |
3032 Highview Ln Mound MN 55364-9422 |
| Practice Telephone | 7639136292 |
| Mailing Telephone | 7639136292 |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2013-07-15 |
| Authorized Official Name | JAMES MICHAEL BALDUS (PSYCHOLOGIST) |
| Authorized Official Telephone | 7639136292 |
| Authorized Official Credential | PHD, LP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
LP0796 | MN | Ambulatory Health Care Facilities |
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
LP0796 | MN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 6500552000 | 05 |
| Street Address |
5200 MAYWOOD RD |
| City | MOUND |
| State | MN |
| Zip Code | 55364-1775 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689681298 | Audrey Mae Frederickson | Psychologist | 5200 Maywood Rd, Suite 202, Mound, MN 55364-1775 | 2006-08-03 |
| 1255736930 | Sojourn Adult Day Services LLC | Clinic/Center | 5200 Maywood Rd, Mound, MN 55364-1775 | 2014-10-24 |
| 1699942623 | Wendy Wright Mattera | Counselor | 5200 Maywood Rd, Suite 202, Mound, MN 55364-1775 | 2008-05-08 |
| 1972688448 | Juli Diane Teien | Marriage & Family Therapist | 5200 Maywood Rd, Suite 202, Mound, MN 55364-1775 | 2006-10-25 |
| 1356424055 | Daniel Paul Doshan | Psychologist | 5200 Maywood Rd, Mound, MN 55364-1775 | 2006-10-24 |
| 1700973773 | James Michael Baldus | Psychologist | 5200 Maywood Rd, Mound, MN 55364-1775 | 2006-10-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962992594 | Mary Kaye Guenther | Physical Therapy Assistant | 6670 Game Farm Rd, Mound, MN 55364 | 2018-05-18 |
| 1558893008 | Kirsten Eaton | Student in an Organized Health Care Education/Training Program | 945 Forest Arms Lanes, Mound, MN 55364 | 2017-04-03 |
| 1619322450 | Heidi Durant | Counselor | 2973 Hazelwood Lane, Mound, MN 55364 | 2016-04-29 |
| 1255720603 | Amanda S Myers | Speech-Language Pathologist | 940 Bayside Ln, Minnetrista, MN 55364 | 2015-01-22 |
| 1538447644 | Mary Bernadette Philp | Dentist | 5205 Shoreline Drive, Mound, MN 55364 | 2011-07-25 |
| 1659600088 | Thomas David Mazer | Anesthesiology | 560 North Arm Drive, Orono, MN 55364 | 2009-12-14 |
| 1205913282 | Robert A Lauer | Dentist | 5585 Shoreline Blvd, Mound, MN 55364 | 2006-11-01 |
| 1750470068 | Stephanie Lynn Miner | Dentist | West Lakes Dentistry, 5205 Shoreline Drive, Mound, MN 55364 | 2006-10-12 |
| 1194120519 | Stable Living LLC | Counselor | 6344 Rambler Ln, Mound, MN 55364-1043 | 2014-10-28 |
| 1386800977 | Debra Karen Kullberg | Marriage & Family Therapist | 1567 Bluebird Ln, Mound, MN 55364-1109 | 2008-08-02 |
| Find all providers in zip 55364 | ||||
| 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] |
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| 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 |
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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.