NPIMap

Organization Active NPI

Northland Counseling Center, Inc.

  • Community/Behavioral Health Agency
  • International Falls, MN
National Provider Identifier
1285903153
Registry record updated Dec 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
801758-1-MHC Issued in MN
Legal business name
NORTHLAND COUNSELING CENTER, INC.
Practice address
900 5TH St
International Falls, MN 56649-2254
Phone
(218) 283-3406
NPI assigned
Dec 22, 2011
Last updated
Dec 22, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2011

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

Authorized official

Name
Mr. Kenneth Gregory Walker
Title
Chief Executive Officer
Phone
(218) 313-1312

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 801758-1-MHC MN Primary

Addresses

Primary practice location

900 5TH St
International Falls, MN 56649-2254

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
894755400MedicaidMN

National Provider Directory

National Provider Directory
Tax ID family
Northland Counselng Ctr10 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

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1324512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324512000000",
    "number": "1285903153",
    "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": "900 5TH ST",
            "city": "INTERNATIONAL FALLS",
            "state": "MN",
            "postal_code": "566492254",
            "telephone_number": "218-283-3406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAND COUNSELING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-22",
        "last_updated": "2011-12-22",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "218-313-1312",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "801758-1-MHC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "894755400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in International Falls, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; 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.