Clearwaters Crosby LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

CLEARWATERS CROSBY LLC

Practice address

14091 Baxter Dr Ste 112
Baxter, MN 56425-8703

Phone

(218) 585-2052

NPI assigned

May 17, 2021

Organization subpart

No

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

Authorized official

Name

Tanya Kubista, LMFTNPI 1154711406

Title

Owner

Phone

(218) 585-2052

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tanya Martha Kubista, MA LMFT

  • Marriage & Family Therapist
  • Baxter, MN
  • NPI 1154711406

  MN

  Medicare reassignment NPD Authorized official
• Theresa Odden, LPCC

  • Mental Health Counselor
  • Baxter, MN
  • NPI 1457025439
  NPD

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782604800000",
    "number": "1093389736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15157 LADYSLIPPER LN",
            "city": "DEERWOOD",
            "state": "MN",
            "postal_code": "564448918",
            "telephone_number": "218-585-2058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14091 BAXTER DR STE 112",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258703",
            "telephone_number": "218-585-2052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARWATERS CROSBY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-17",
        "last_updated": "2026-06-28",
        "certification_date": "2026-06-28",
        "status": "A",
        "authorized_official_last_name": "KUBISTA",
        "authorized_official_first_name": "TANYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-585-2052",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154711406",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093389736",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karla Christensen, LADC
• Kelli Jo Christenson
• Sandra Jean Ann Christner, CHW
• Breena Dell Clayton, O.D.
• Daniel B Clayton, O.D.
• Scott Cameron Close, D.C.
• Kate Coffman
• Nicole Marie Cole, PA-C
• Samantha Cole, LAFMT
• Community Behavioral Health Hospital-Baxter

• All providers in Baxter, MN
• Mental Health Clinic/Center (Including Community Mental Health Center) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2026; 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.