NPIMap

Organization Active NPI

Northern Pines Mental Health Center, Inc.

  • Community/Behavioral Health Agency
  • Brainerd, MN
National Provider Identifier
1225168602
Registry record updated Dec 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
09635 Issued in MN
Legal business name
NORTHERN PINES MENTAL HEALTH CENTER, INC.
Practice address
520 NW 5TH St
Brainerd, MN 56401-2902
Phone
(218) 821-7818
NPI assigned
Mar 6, 2007
Last updated
Dec 2, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2019

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

Authorized official

Name
Laura L Vaughn
Title
Executive Director
Phone
(320) 632-6647

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 09635 MN Primary

Addresses

Primary practice location

520 NW 5TH St
Brainerd, MN 56401-2902

Mailing address

PO Box 367
Little Falls, MN 56345-0367
Phone (320) 632-6647

Other identifiers 1

IdentifierTypeStateIssuer
767215200MedicaidMN

National Provider Directory

National Provider Directory
Tax ID family
Northern Pines MHC Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

823 Maple St
Brainerd, MN 56401
Phone (218) 454-3826

16 9th St SE
Long Prairie, MN 56347
Phone (320) 732-6602

200 4th St NE
Staples, MN 56479
Phone (218) 541-5043

11 2nd St SW
Ste 1
Wadena, MN 56482
Phone (218) 631-1714

Practitioners & affiliated clinicians

Practitioners 71

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 71

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575244800000",
    "number": "1225168602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 367",
            "city": "LITTLE FALLS",
            "state": "MN",
            "postal_code": "563450367",
            "telephone_number": "320-632-6647",
            "fax_number": "320-639-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 NW 5TH ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564012902",
            "telephone_number": "218-821-7818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN PINES MENTAL HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2019-12-02",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "320-632-6647"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "09635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "767215200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brainerd, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; 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.