NPIMap

Organization Active NPI

Lakes Country Counseling PLLC

  • Community/Behavioral Health Agency
  • Baxter, MN
National Provider Identifier
1023322351
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
1531 Issued in MN
Legal business name
LAKES COUNTRY COUNSELING PLLC
Practice address
7251 Excelsior Rd
Baxter, MN 56425
Phone
(218) 454-0878
Fax
(218) 454-0879
NPI assigned
Jul 28, 2010
Last updated
Jul 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Stephen Vagle, LMFTNPI 1366616146
Title
Owner
Phone
(218) 454-0878

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 1531 MN Primary

Addresses

Primary practice location

7251 Excelsior Rd
Baxter, MN 56425

Mailing address

7251 Excelsior Rd
Baxter, MN 56425-8477
Phone (218) 454-0878

Other practice location 1

16350 11th St NE
Little Falls, MN 56345-6400
Phone (320) 639-0878

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161025000047 MN Part B Supplier - Clinic/Group Practice 7214257849 Receives reassigned benefits from 9 practitioners
Practice locations: Baxter, MN; Little Falls, MN

National Provider Directory

National Provider Directory

Locations

7251 Excelsior Rd
Baxter, MN 56425
Phone (218) 454-0878

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1280275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688342400000",
    "number": "1023322351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7251 EXCELSIOR RD",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258477",
            "telephone_number": "218-454-0878",
            "fax_number": "218-454-0879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7251 EXCELSIOR RD",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "56425",
            "telephone_number": "218-454-0878",
            "fax_number": "218-454-0879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16350 11th St NE",
            "address_purpose": "LOCATION",
            "city": "Little Falls",
            "state": "MN",
            "postal_code": "563456400",
            "country_code": "US",
            "telephone_number": "320-639-0878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LAKES COUNTRY COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-28",
        "last_updated": "2023-07-03",
        "certification_date": "2023-06-20",
        "status": "A",
        "authorized_official_last_name": "VAGLE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-454-0878",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "1531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baxter, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.