LAUREN SHALANE WAGENDORF (NPI# 1821533035) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821533035 |
| Entity Type | Individual |
| Full Name | LAUREN SHALANE WAGENDORF |
| Other Name | LAUREN SHALANE HENRY |
| Credential | LPCC |
| Practice Address |
603 Bruce St Crookston MN 56716 |
| Mailing Address |
603 Bruce St Po Box 603 Crookston MN 56716-2914 |
| Practice Telephone | 2182815256 |
| Practice Fax Number | 2182812473 |
| Mailing Telephone | 2182813940 |
| Mailing Fax Number | 2182816261 |
| Enumeration Date | 2016-12-23 |
| Last Update Date | 2018-08-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
CC01367 | MN | Behavioral Health & Social Service Providers |
| Street Address |
603 BRUCE ST |
| City | CROOKSTON |
| State | MN |
| Zip Code | 56716 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508835133 | Northwestern Mental Health Center | Clinic/Center | 603 Bruce St, Crookston, MN 56716 | 2006-03-16 |
| 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 |
| Find all providers in the same location | ||||
| 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 | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700230257 | Brianne Christine Thompson | Counselor | 603 Bruce St, Crookston, MN 56716-2914 | 2016-04-21 |
| 1053691436 | Heather Taylor | Counselor | 603 Bruce St, Crookston, MN 56716-2914 | 2011-08-17 |
| 1679897383 | Carrie Serna | Counselor | 603 Bruce St, Crookston, MN 56716-2914 | 2010-03-24 |
| 1972825560 | Sheri Lynn Solheim | Counselor | 603 Bruce St, Crookston, MN 56716-2914 | 2010-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144188 | Bonnie Rose Theis | Counselor | 24 3rd Ave Ne, Unit B, Osseo, MN 55369 | 2020-11-06 |
| 1578162012 | Bemidji Autism and Children's Therapy LLC | Counselor | 522 Beltrami Ave Nw Ste 110, Bemidji, MN 56601-3002 | 2020-10-24 |
| 1235746579 | Kesha L Bradford | Counselor | 4315 Irving Ave N, Minneapolis, MN 55412-1258 | 2020-09-30 |
| 1386251163 | Jeffrey D Larson, LLC | Counselor | 11735 90th Ave, Milaca, MN 56353-3894 | 2020-09-25 |
| 1407462849 | Anthony Arthur Duhn | Counselor | 6160 Summit Dr N Ste 375, Brooklyn Center, MN 55430-2251 | 2020-09-21 |
| 1043826746 | Amanda Anderson | Counselor | 3201 1st Ave S, Minneapolis, MN 55408-4407 | 2020-09-17 |
| 1720694722 | Eleanor (ellie) Freerksen | Counselor | 3 3rd Ave Sw, Dodge Center, MN 55927 | 2020-09-16 |
| 1033724356 | Carmen Iverson | Counselor | 13401 Morgan Ave S Apt 133, Burnsville, MN 55337-2058 | 2020-09-14 |
| 1235744640 | Paige Berg | Counselor | 6053 Hudson Rd Ste 344, Woodbury, MN 55125-1011 | 2020-09-11 |
| 1508479700 | Roy Haddad | Counselor | 5861 Cedar Lake Rd, St Louis Park, MN 55416-1653 | 2020-08-26 |
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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.