ADDICTIONS & STRESS CLINIC (NPI# 1992085674) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992085674 |
| Entity Type | Organization |
| Organization Name | ADDICTIONS & STRESS CLINIC |
| Other Organization Name | ASC PSYCHOLOGICAL SERVICES |
| Practice Address |
12 Civic Center Plz Suite 2090 Mankato MN 56001-7781 |
| Practice Telephone | 5073454679 |
| Practice Fax Number | 5073458685 |
| Mailing Telephone | 5073454679 |
| Mailing Fax Number | 5073458685 |
| Enumeration Date | 2011-08-25 |
| Last Update Date | 2011-08-25 |
| Authorized Official Name | DR. GEORGE V KOMARIDIS (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 5073454679 |
| Authorized Official Credential | PH.D., LP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | LP1673 | MN | Agencies |
| Other Name | Type Code |
|---|---|
| ASC PSYCHOLOGICAL SERVICES | Doing Business As Name - Organization |
| Street Address |
12 CIVIC CENTER PLZ SUITE 2090 |
| City | MANKATO |
| State | MN |
| Zip Code | 56001-7781 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124297213 | George V Komaridis | Psychologist | 12 Civic Center Plz, Suite 2090, Mankato, MN 56001-7781 | 2008-02-22 |
| 1275083784 | Laura L. Benesch | Social Worker | 12 Civic Center Plz, 1615, Mankato, MN 56001-7781 | 2016-10-07 |
| 1396198057 | James Curtis Murphy | Counselor | 12 Civic Center Plz, Suite 2116, Mankato, MN 56001-7781 | 2016-07-18 |
| 1083040612 | Timothy K Benesch | Marriage & Family Therapist | 12 Civic Center Plz, Suite 1615, Mankato, MN 56001-7781 | 2013-09-14 |
| 1609200690 | Julene D Nolan | Psychologist | 12 Civic Center Plz, Suite 1615, Mankato, MN 56001-7781 | 2013-08-26 |
| 1457617185 | Julie C Melzer | Counselor | 12 Civic Center Plz, Suite 1615, Mankato, MN 56001-7781 | 2012-04-06 |
| 1376820118 | Addictions and Stress Clinics Ltd | Counselor | 12 Civic Center Plz, Suite 1615, Mankato, MN 56001-7783 | 2011-11-08 |
| 1265720049 | Jean L Zenk | Counselor | 12 Civic Center Plz, Suite 2090, Mankato, MN 56001-7781 | 2011-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154935435 | Kelly Nicole Ricke | Physical Medicine & Rehabilitation | 1 Civic Center Plaza, Hockey Office Complex, Mankato, MN 56001 | 2020-09-03 |
| 1649816786 | Ashley Lynn Walters | Technician, Other | 501 Madison Ave., Mankato, MN 56001 | 2019-11-25 |
| 1720631716 | Dovetail Traslation LLC | Interpreter | 212 Dublin Ct, Same As Above, Mankato, MN 56001 | 2019-07-19 |
| 1093377871 | Lindsey Keithahn | Counselor | 2100 Bassett Drive, Mankato, MN 56001 | 2019-07-02 |
| 1255803813 | Amy Marie Williams | Acupuncturist | 709 S. Front Street, Suite 5, Mankato, MN 56001 | 2018-12-20 |
| 1518437573 | Ashley Blanchard | Acupuncturist | Vida Salon Suites 1351 Madison Avenue, Suite F/ Suite 206, Mankato, MN 56001 | 2018-12-03 |
| 1831687235 | Christian Goetz | Specialist/Technologist | 401-477 South Rd, Mankato, MN 56001 | 2018-05-01 |
| 1366949141 | Minnesota State College and Universities | Specialist/Technologist | 135 Myers Field House, Mankato, MN 56001 | 2018-04-09 |
| 1780191775 | Kevin David Nelson | Pharmacist | 111 Redtail Ct Apt 308, Mankato, MN 56001 | 2017-12-29 |
| 1972014231 | Rylee Wagner | Speech-Language Pathologist | Mankato Clinic Pediatric Therapy Services, 150 St. Andrews Court, Suite 310, Mankato, MN 56001 | 2017-10-13 |
| Find all providers in zip 56001 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346730058 | Family Decisions LLC | Community/Behavioral Health | 510 Long St Ste 100, Mankato, MN 56001-4397 | 2018-05-17 |
| 1477004497 | Kaire LLC | Community/Behavioral Health | 100 Warren St Ste 316, Mankato, MN 56001-3762 | 2016-10-14 |
| 1023285954 | Mankato Rehabilitation Center, Inc. | Community/Behavioral Health | 15 Map Dr, Mankato, MN 56001-8944 | 2008-05-09 |
| 1649397092 | Bonnie-lyn II, Inc. | Community/Behavioral Health | 430 Patterson Ave, Mankato, MN 56001-2309 | 2007-03-23 |
| 1447692082 | Transitions Mediation and Counseling | Community/Behavioral Health | 301 N 6th St, Mankato, MN 56001-4448 | 2013-07-24 |
| 1861831240 | Helping Hands Healing Hearts Center | Community/Behavioral Health | 915 S Front St, Mankato, MN 56001-2404 | 2013-06-19 |
| 1821389214 | Horizon Homes, Inc. | Community/Behavioral Health | 521 Pfau St, Mankato, MN 56001-7032 | 2011-04-20 |
| 1689990665 | Mankato Marriage and Family Therapy Center | Community/Behavioral Health | 510 Long St, Suite 101, Mankato, MN 56001-4397 | 2010-04-15 |
| 1164675344 | Phoenix Group Homes, Inc. | Community/Behavioral Health | 227 E Main St, Suite 105, Mankato, MN 56001-7732 | 2008-10-31 |
| 1083863245 | Mankato Mental Health Associates, Pa | Community/Behavioral Health | 209 S Broad St, Suite C, Mankato, MN 56001-3681 | 2008-09-11 |
| Find all providers in MANKATO | ||||
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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.