NPIMap

Organization Active NPI

Carver County

Doing business as Carver County Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waconia, MN
National Provider Identifier
1326049685
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
800823-3-MHC Issued in MN
Legal business name
CARVER COUNTY
Doing business as
Carver County Mental Health
Practice address
540 E 1St St
Waconia, MN 55387-1601
Phone
(952) 442-4437
Fax
(952) 442-3084
NPI assigned
Aug 9, 2005
Last updated
Jun 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Authorized official

Name
Heather Goodwin
Title
Director
Phone
(952) 361-1660

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 800823-3-MHC MN Primary

Addresses

Primary practice location

540 E 1St St
Waconia, MN 55387-1601

Mailing address

540 E 1St St
Waconia, MN 55387-1601
Phone (952) 442-4437

Other names 2

  • Carver County Mental Health Doing business as
  • First Street Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040609000094 MN Part B Supplier - Clinic/Group Practice 8527041961 Receives reassigned benefits from 17 practitioners
Practice locations: Waconia, MN

National Provider Directory

National Provider Directory
Tax ID family
Carver County Mental He3 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.

  • Carver County

    dba Carver County Public Health

    • Public Health or Welfare Agency
    • Chaska, MN
    • NPI 1003020165
    NPD tax ID
  • Carver County

    dba Carver County Health and Human Services

    • Case Management Agency
    • Chaska, MN
    • NPI 1912355652
    NPD tax ID

Locations

303 E 6th St
Chaska, MN 55318
Phone (612) 280-5075

540 E 1st St
Waconia, MN 55387
Phone (952) 442-4437

Practitioners & affiliated clinicians

Practitioners 60

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 60

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686614400000",
    "number": "1326049685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 E 1ST ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871601",
            "telephone_number": "952-442-4437",
            "fax_number": "952-442-3084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 E 1ST ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871601",
            "telephone_number": "952-442-4437",
            "fax_number": "952-442-3084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARVER COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A",
        "authorized_official_last_name": "GOODWIN",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "952-361-1660"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MN",
            "license": "800823-3-MHC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carver County Mental Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "First Street Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Waconia, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; 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.