Northern Lakes Clinic, Inc.

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

1045771-1-CDT Issued in MN

Legal business name

NORTHERN LAKES CLINIC, INC.

Doing business as

Northern Lakes Clinic

Practice address

301 America Ave NW
Bemidji, MN 56601-3120

Phone

(218) 755-5170

Fax

(218) 751-1194

NPI assigned

Jan 23, 2007

Last updated

Aug 22, 2020By 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

Dr. Lois Cochrane Schlutter, PH.D.NPI 1396839684

Title

Ceo & Owner

Phone

(952) 925-5344

Specialties & licenses 1

Addresses

Other names 1

• Northern Lakes Clinic Doing business as

Tax ID family

Northern Lakes Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Northern Lakes Clinic, Inc.

  dba Northern Lakes Clinic

  • Methadone Clinic
  • Bemidji, MN
  • NPI 1750435459
  NPD tax ID

Locations

Practitioners 1

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.

• Lois Cochrane Schlutter, PHD LP

  • Clinical Psychologist
  • St Louis Park, MN
  • NPI 1396839684
  Authorized official Same address or phone

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114071420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 EXCELSIOR BLVD",
            "address_2": "SUITE 202",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162730",
            "telephone_number": "952-925-5344",
            "fax_number": "952-548-9350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 AMERICA AVE NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566013120",
            "telephone_number": "218-755-5170",
            "fax_number": "218-751-1194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN LAKES CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCHLUTTER",
        "authorized_official_first_name": "LOIS",
        "authorized_official_middle_name": "COCHRANE",
        "authorized_official_title_or_position": "CEO & OWNER",
        "authorized_official_telephone_number": "952-925-5344",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MN",
            "license": "1045771-1-CDT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Lakes Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Margaret Nordquist, CHW CERTIFICATE
• North Country Dental Service
• North Country Health Services (North Country Regional Hospital)
• North Country Health Services (North Country Regional Hospital)
• North Country Medical Clinic (Northern Medical Clinic)
• Northern Lakes Clinic, Inc. (Northern Lakes Clinic)
• Northern Minnesota Addiction Wellness Center
• Northern Safety & Security LLC
• Northern Therapy and Consulting, LLC
• Northland Nutrition Consulting, LLC

• Substance Use Disorder Rehabilitation Clinic/Center in Bemidji, MN
• Providers in Bemidji, MN by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Minnesota

• 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.