Woodland Centers
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Willmar, MN
NPI 1104909779 · NPPES record last updated Aug 3, 2017
Key facts
- NPI
- 1104909779
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- License
- 830946 (MN)
- Legal business name
- WOODLAND CENTERS
- Practice address
- 1125 6TH St SE
Willmar, MN 56201-0787 - Phone
- (320) 235-4613
- Fax
- (320) 231-9140
- NPI assigned
- Oct 24, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- WOODLAND CENTERS
Authorized official
- Name
- Dr. Ashley Kjos
- Title
- Ceo
- Phone
- (320) 235-4613
Corporate family (same tax ID) 5
Practitioners 3
-
Sarah Marie Coughlin, LADC
-
Ashley Ann Kjos, PSY.D.
-
Veronica Harsh, M.D.
National Provider Directory
- Tax ID family
- West Central Comm SVC C
- Part of
- West Central Comm SVC C
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | 830946 | MN | Yes |
Addresses
Primary practice location
1125 6TH St SE
Willmar, MN 56201-0787
Mailing address
1125 6TH St SE
Willmar, MN 56201-0787
Phone (320) 235-4613
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 684569000 | Medicaid | MN |
Other names
- West Central Community Services Center
Other providers in Willmar, MN
- Stephanie Lynn Wimmer
- Kaisa J Winckler
- Heidi Winter
- Libby Wirth
- Megan Ann Woller
- Woodland Centers
- Woodland Centers
- Woodland Centers
- Woodland Centers
- Malissa L Wooner-Boland
All providers in Willmar, MN · Mental Health Clinic/Center (Including Community Mental Health Center) in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 3, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.