NPIMap

Organization Active NPI

Northland Counseling Center, Inc.

  • Community/Behavioral Health Agency
  • Grand Rapids, MN
National Provider Identifier
1164610986
Registry record updated Oct 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
NORTHLAND COUNSELING CENTER, INC.
Practice address
215 SE 2ND Ave
Grand Rapids, MN 55744-3615
Phone
(218) 326-1274
NPI assigned
Oct 5, 2007
Last updated
Oct 5, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2007

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

Authorized official

Name
K. Greg Walker
Title
Ceo
Phone
(218) 326-0099

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

215 SE 2ND Ave
Grand Rapids, MN 55744-3615

Mailing address

215 SE 2ND Ave
Grand Rapids, MN 55744-3615

Other identifiers 1

IdentifierTypeStateIssuer
72560NOOtherMNBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041221000396 MN Part B Supplier - Clinic/Group Practice 1153389242 Receives reassigned benefits from 28 practitioners
1 other NPI on this enrollment
Practice locations: International Falls, MN; Hibbing, MN; Grand Rapids, MN; Baudette, MN; Aitkin, MN
O20210913002112 TN Part B Supplier - Clinic/Group Practice 1153389242 Receives reassigned benefits from 1 practitioner
Practice locations: Centerville, TN

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Northland Counseling Center Kooch Office10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

20 3rd St NE
Aitkin, MN 56431
Phone (218) 326-1274

3130 SE 2nd Ave
Grand Rapids, MN 55744
Phone (218) 256-1131

301 E Howard St
Ste 1
Hibbing, MN 55746
Phone (218) 326-1274

1902 Valley Pine Cir
International Falls, MN 56649
Phone (218) 283-3406

900 5th St
Ste 305
International Falls, MN 56649
Phone (218) 283-3406

1404 Hwy 71
Intl Falls, MN 56649
Phone (218) 283-3406

Practitioners & affiliated clinicians

Practitioners 33

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 33

NPI Registry JSON

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191542400000",
    "number": "1164610986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 SE 2ND AVE",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 SE 2ND AVE",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443615",
            "telephone_number": "218-326-1274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAND COUNSELING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-05",
        "last_updated": "2007-10-05",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "K.",
        "authorized_official_middle_name": "GREG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "218-326-0099"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "72560NO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; 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.