Organization Active NPI

Individual and Family Services, Inc.

  • Community/Behavioral Health Agency
  • Albert Lea, MN
National Provider Identifier
1295999746
Registry record updated Jul 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
06629 Issued in MN
Legal business name
INDIVIDUAL AND FAMILY SERVICES, INC.
Practice address
111 E Clark St Ste 201
Albert Lea, MN 56007-4580
Phone
(507) 377-2224
Fax
(507) 377-2224
NPI assigned
Jul 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2008

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

Authorized official

Name
Edith Marie Haenel, LICSWNPI 1164521613
Title
Therapist/President
Phone
(507) 377-2224

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
Community/Behavioral Health Agency 251S00000X 06629 MN Primary

Addresses

Primary practice location

111 E Clark St Ste 201
Albert Lea, MN 56007-4580

Mailing address

111 E Clark St Ste 201
Albert Lea, MN 56007-4580
Phone (507) 377-2224

Other identifiers 1

IdentifierTypeStateIssuer
011357300MedicaidMN

National Provider Directory

National Provider Directory

Locations

111 E Clark St
Ste 201
Albert Lea, MN 56007
Phone (507) 377-2224

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": "1215993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1295999746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E CLARK ST STE 201",
            "city": "ALBERT LEA",
            "state": "MN",
            "postal_code": "560074580",
            "telephone_number": "507-377-2224",
            "fax_number": "507-377-2224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E CLARK ST STE 201",
            "city": "ALBERT LEA",
            "state": "MN",
            "postal_code": "560074580",
            "telephone_number": "507-377-2224",
            "fax_number": "507-377-2224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIVIDUAL AND FAMILY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-14",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "HAENEL",
        "authorized_official_first_name": "EDITH",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "THERAPIST/PRESIDENT",
        "authorized_official_telephone_number": "507-377-2224",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "06629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011357300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albert Lea, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; 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.