Organization Active NPI

Fresh Outlook, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Elk River, MN
National Provider Identifier
1205697885
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
FRESH OUTLOOK, PLLC
Practice address
657 Main St NW Ste 104
Elk River, MN 55330-1578
Phone
(612) 439-3084
NPI assigned
Jan 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Authorized official

Name
Maura Freshour, LICSWNPI 1588434328
Title
Owner
Phone
(404) 277-4774

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

657 Main St NW Ste 104
Elk River, MN 55330-1578

Mailing address

657 Main St NW Ste 104
Elk River, MN 55330-1578
Phone (612) 439-3084

National Provider Directory

National Provider Directory

Locations

657 Main St NW
Ste 104
Elk River, MN 55330
Phone (612) 439-3084

657 Main St NW
Ste 206
Elk River, MN 55330

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1705622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717372800000",
    "number": "1205697885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 MAIN ST NW STE 104",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553301578",
            "telephone_number": "612-439-3084",
            "fax_number": "612-500-4796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 MAIN ST NW STE 104",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553301578",
            "telephone_number": "612-439-3084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESH OUTLOOK, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-19",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A",
        "authorized_official_last_name": "FRESHOUR",
        "authorized_official_first_name": "MAURA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-277-4774",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk River, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.