Northeast Counseling, P.a.

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

NORTHEAST COUNSELING, P.A.

Practice address

2127 County Road D E Ste A100
Maplewood, MN 55109-5350

Phone

(651) 592-1592

Fax

(651) 429-2988

NPI assigned

Jan 3, 2008

Last updated

Apr 2, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tim G Scott, LICSW

Title

President

Phone

(651) 398-6341

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 5

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.

• Daniel Jon Hinderaker, MSW, LICSW

  • Clinical Social Worker
  • Maplewood, MN
  • NPI 1467908277
  Medicare reassignment Care Compare group NPD
• Debra Kay Kratz, LICSW

  • Clinical Social Worker
  • Maplewood, MN
  • NPI 1811031180
  Medicare reassignment Care Compare group NPD
• Clayton David Sankey, LICSW

  • Clinical Social Worker
  • North Saint Paul, MN
  • NPI 1003863531
  Medicare reassignment Care Compare group NPD
• Timothy Scott, LICSW

  • Clinical Social Worker
  • Maplewood, MN
  • NPI 1548304850
  Medicare reassignment Care Compare group NPD
• Jael Were

  • Marriage & Family Therapist
  • Maplewood, MN
  • NPI 1639403967
  Medicare reassignment NPD

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522627200000",
    "number": "1053596577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2127 COUNTY ROAD D E STE A100",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551095350",
            "telephone_number": "651-592-1592",
            "fax_number": "651-429-2988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2127 COUNTY ROAD D E STE A100",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551095350",
            "telephone_number": "651-592-1592",
            "fax_number": "651-429-2988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST COUNSELING, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-03",
        "last_updated": "2018-04-02",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "TIM",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-398-6341",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053596577",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ericka Michelle Niemann, OT
• Catherine Wanjiru Njogu, B.A., D.C.
• Patricia Ann Nord, RN
• Katherine J Norelius, CRNA
• Hanna Rose Norlen
• Northland Hearing Centers, Inc (Associated Hearing Inst. of Maplewood)
• Northland Hearing Centers, Inc. (Associated Hearing of Maplewood)
• Jennifer Novak
• Novo Psychological Services, LLC
• William Thomas O'Brien

• Adolescent and Children Mental Health Clinic/Center in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Adolescent and Children Mental Health Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2018; 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.