Trista Marie Carlson
Individual provider Active NPI Behavior Technician · Virginia, MN
NPI 1003589813 · NPPES record last updated Jul 28, 2021
Key facts
- NPI
- 1003589813
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 910 8TH St S Ste B
Virginia, MN 55792-3236 - Phone
- (218) 748-8500
- NPI assigned
- Jul 28, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iron Range Behavioral Services, LLC | Current |
Accepting new patients |
Locations
910 8th St S
Ste B
Virginia, MN 55792
Phone (218) 748-8500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
910 8TH St S Ste B
Virginia, MN 55792-3236
Mailing address
910 8TH St S Ste B
Virginia, MN 55792-3236
Phone (218) 748-8500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A450055500 | Other | MN | UMPI |
Other providers in Virginia, MN
- Calla
- Calm Waters Therapy, LLC
- Claire Y Carlson
- Darian Carlson
- Dennis Lee Carlson
- Mary J Carpenter
- Roxanne Lanae Carter-Wyatt
- Joseph F Carter
- Brenda Lee Cary
- Joseph B. Caulfield
All providers in Virginia, MN · Behavior Technician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.