NPIMap

Organization Active NPI

Central Minnesota Mental Health Center

  • Counselor
  • Saint Cloud, MN
National Provider Identifier
1053576546
Registry record updated Jan 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
CENTRAL MINNESOTA MENTAL HEALTH CENTER
Practice address
3333 W Division St
Suite 219
Saint Cloud, MN 56301-4515
Phone
(320) 257-4230
Fax
(320) 257-2201
NPI assigned
Jul 23, 2008
Last updated
Jan 7, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2010

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

Authorized official

Name
Mr. David J Baraga, PHD LPNPI 1679519789
Title
Executive Director
Phone
(320) 252-5010

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU Primary

Addresses

Primary practice location

3333 W Division St
Suite 219
Saint Cloud, MN 56301-4515

Mailing address

3333 W Division St
Suite 219
Saint Cloud, MN 56301-4515
Phone (320) 257-4230

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040119000248 MN Part B Supplier - Clinic/Group Practice 4486555877 Receives reassigned benefits from 47 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Monticello, MN; Waite Park, MN; Saint Cloud, MN; Elk River, MN; Buffalo, MN

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

308 12th Ave S
Buffalo, MN 55313
Phone (763) 682-4400

253 8th St NW
Ste A
Elk River, MN 55330
Phone (763) 441-3770

730 Dodge Ave
Ste 101
Elk River, MN 55330
Phone (763) 441-3770

1509 24th Ave N
Saint Cloud, MN 56303
Phone (320) 252-5010

3333 W Division St
Ste 209
Saint Cloud, MN 56301
Phone (320) 253-5555

3333 W Division St
Ste 217
Saint Cloud, MN 56301
Phone (320) 253-4120

3333 W Division St
Ste 218
Saint Cloud, MN 56301
Phone (320) 252-4230

3333 W Division St
Ste 219
Saint Cloud, MN 56301
Phone (320) 257-4230

Practitioners & affiliated clinicians

Practitioners 59

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 59

NPI Registry JSON

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262822400000",
    "number": "1053576546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 W DIVISION ST",
            "address_2": "SUITE 219",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014515",
            "telephone_number": "320-257-4230",
            "fax_number": "320-257-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 W DIVISION ST",
            "address_2": "SUITE 219",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014515",
            "telephone_number": "320-257-4230",
            "fax_number": "320-257-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL MINNESOTA MENTAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-23",
        "last_updated": "2010-01-07",
        "status": "A",
        "authorized_official_last_name": "BARAGA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "320-252-5010",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHD LP"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2010; 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.