Calm Waters Therapy, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

2859 Issued in MN

Legal business name

CALM WATERS THERAPY, LLC

Practice address

601 S 2ND Ave
Virginia, MN 55792-2705

Phone

(218) 404-9611

Fax

(218) 414-2600

NPI assigned

Feb 8, 2018

Last updated

Feb 8, 2018By 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

Ms. Jennifer Ann Moreland, MS, LMFTNPI 1801253034

Title

Mental Health Therapist/Owner

Phone

(218) 404-9611

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 2

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.

• Jennifer Ann Moreland, LMFT

  • Marriage & Family Therapist
  • Virginia, MN
  • NPI 1801253034
  Medicare reassignment NPD Authorized official
• Jill Burkes, OT

  • Occupational Therapist
  • Virginia, MN
  • NPI 1780918664
  NPD (past)

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

{
    "created_epoch": "1518048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518048000000",
    "number": "1235638982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 13TH ST N",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557922241",
            "telephone_number": "218-404-9611",
            "fax_number": "218-414-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S 2ND AVE",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557922705",
            "telephone_number": "218-404-9611",
            "fax_number": "218-414-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALM WATERS THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-08",
        "last_updated": "2018-02-08",
        "status": "A",
        "authorized_official_last_name": "MORELAND",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "MENTAL HEALTH THERAPIST/OWNER",
        "authorized_official_telephone_number": "218-404-9611",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS, LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MN",
            "license": "2859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cecilia Rose Burke
• Jill Burkes, OT
• Aaron R Burkhart, MD
• Elizabeth Elam Burton
• Calla
• Claire Y Carlson
• Darian Carlson
• Dennis Lee Carlson, DDS
• Trista Marie Carlson
• Mary J Carpenter, MS ED LP

• Mental Health Clinic/Center (Including Community Mental Health Center) in Virginia, MN
• Providers in Virginia, MN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; 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.