NPIMap

Organization Active NPI

Lakeview Behavioral Health LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Grand Rapids, MN
National Provider Identifier
1164881561
Registry record updated Apr 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
CNP 2950 Issued in MN
Legal business name
LAKEVIEW BEHAVIORAL HEALTH LLC
Practice address
520 NW 1St Ave Ste 5
Grand Rapids, MN 55744-2619
Phone
(218) 302-4468
Fax
(218) 302-1457
NPI assigned
Feb 15, 2016
Last updated
Apr 13, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2016

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

Authorized official

Name
Thomas Johnson, APRN, CNPNPI 1609051168
Title
President
Phone
(218) 302-4468

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X CNP 2950 MN Primary

Addresses

Primary practice location

520 NW 1St Ave Ste 5
Grand Rapids, MN 55744-2619

Mailing address

520 NW 1St Ave Ste 5
Grand Rapids, MN 55744-2619

National Provider Directory

National Provider Directory

Locations

520 NW 1st Ave
Ste 5
Grand Rapids, MN 55744
Phone (218) 327-7973

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460505600000",
    "number": "1164881561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 NW 1ST AVE STE 5",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557442619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 NW 1ST AVE STE 5",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557442619",
            "telephone_number": "218-302-4468",
            "fax_number": "218-302-1457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVIEW BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-15",
        "last_updated": "2016-04-13",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "218-302-4468",
        "authorized_official_credential": "APRN, CNP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MN",
            "license": "CNP 2950",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 13, 2016; 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.