NPIMap

Organization Active NPI

City of White Bear Lake MN

  • Community/Behavioral Health Agency
  • White Bear Lake, MN
National Provider Identifier
1053483248
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
8026811MHC Issued in MN
Legal business name
CITY OF WHITE BEAR LAKE MN
Practice address
1280 North Birch Lake Blvd
White Bear Lake Area Community Counseling Center
White Bear Lake, MN 55110-6708
Phone
(651) 429-8544
Fax
(651) 407-5301
NPI assigned
Nov 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Julie Belle Williams, MSW LICSW LP LMFT LI
Title
Director Administrative & Clinical
Phone
(651) 429-8544

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 8026811MHC MN Primary

Addresses

Primary practice location

1280 North Birch Lake Blvd
White Bear Lake Area Community Counseling Center
White Bear Lake, MN 55110-6708

Mailing address

1280 North Birch Lake Blvd
White Bear Lake Area Community Counseling Center
White Bear Lake, MN 55110-6708
Phone (651) 429-8544

Other identifiers 3

IdentifierTypeStateIssuer
N008855OtherCHAMPUS CLINIC #
29626WHOtherMNBLUE CROSS BLUE SHIELD
102981OtherMNUCARE MINNESOTA CLINIC #

Other names 1

  • White Bear Lake Area Community Counseling Center Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053483248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1280 NORTH BIRCH LAKE BLVD",
            "address_2": "WHITE BEAR LAKE AREA COMMUNITY COUNSELING CENTER",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551106708",
            "telephone_number": "651-429-8544",
            "fax_number": "651-407-5301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280 NORTH BIRCH LAKE BLVD",
            "address_2": "WHITE BEAR LAKE AREA COMMUNITY COUNSELING CENTER",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551106708",
            "telephone_number": "651-429-8544",
            "fax_number": "651-407-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF WHITE BEAR LAKE MN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "BELLE",
        "authorized_official_title_or_position": "DIRECTOR ADMINISTRATIVE & CLINICAL",
        "authorized_official_telephone_number": "651-429-8544",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSW LICSW LP LMFT LI"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "8026811MHC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS CLINIC #",
            "identifier": "N008855",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "29626WH",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE MINNESOTA CLINIC #",
            "identifier": "102981",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "White Bear Lake Area Community Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in White Bear Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.