Active NPI
Lakeland Mental Health Center, Inc.
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Fergus Falls, MN
National Provider Identifier
1366480287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)
- License
- 801338-1-MHC
- Legal business name
- LAKELAND MENTAL HEALTH CENTER, INC.
- Practice address
- 980 S Tower Rd
Fergus Falls, MN 56537-5505 - Phone
- (218) 736-6987
- Fax
- (218) 736-0734
- NPI assigned
- Jun 3, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Donna Baker
- Title
- Ceo
- Phone
- (218) 299-6669
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | 434755200 | MN | |
| Case Management Agency | 251B00000X | 434755211 | MN | |
| Case Management Agency | 251B00000X | 434755212 | MN | |
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | 801338-1-MHC | MN | Primary |
Addresses
Primary practice location
980 S Tower Rd
Fergus Falls, MN 56537-5505
Mailing address
980 S Tower Rd
Fergus Falls, MN 56537-5505
Phone (218) 736-6987
Other practice location 1
1010 32nd Ave S
Moorhead, MN 56560-5001
Phone (218) 233-7524
Other practice location 2
928 8th St SE
Detroit Lakes, MN 56501-2839
Phone (218) 847-1676
Other practice location 3
14 6th Ave NW
Glenwood, MN 56334-1160
Phone (320) 634-3446
Other practice location 4
702 34th Ave E
Alexandria, MN 56308-2599
Phone (320) 762-2400
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 434755212 | Medicaid | MN | |
| 030701035 | Other | MN | PRIME WEST HEALTH SYSTEM |
| 250357300 | Medicaid | MN | |
| 434755211 | Medicaid | MN | |
| 109513 | Other | MN | UCARE MINNESOTA |
| 434755200 | Medicaid | MN | |
| 62522LA | Other | MN | BLUE SHIELD OF MINNESOTA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031105000073 | MN | Part B Supplier - Clinic/Group Practice | 1759291891 |
Receives reassigned benefits from 44 practitioners Practice locations: Detroit Lakes, MN; Moorhead, MN; Glenwood, MN; Fergus Falls, MN; Alexandria, MN |
National Provider Directory
National Provider DirectoryLocations
700 Cedar St
Ste 154
Alexandria, MN 56308
Phone (320) 762-2400
702 34th Ave E
Alexandria, MN 56308
Phone (320) 762-2400
928 8th St SE
Detroit Lakes, MN 56501
Phone (218) 847-1676
980 S Tower Rd
#1541
Fergus Falls, MN 56537
126 E Alcott Ave
Fergus Falls, MN 56537
Phone (218) 736-6987
14 6th Ave NW
Glenwood, MN 56334
Phone (320) 634-3446
Practitioners & affiliated clinicians
Practitioners 69
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Detroit Lakes, MN
- NPI 1326887753
MN
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149292800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1632096000000",
"number": "1366480287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "980 S TOWER RD",
"city": "FERGUS FALLS",
"state": "MN",
"postal_code": "565375505",
"telephone_number": "218-736-6987",
"fax_number": "218-736-0734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "980 S TOWER RD",
"city": "FERGUS FALLS",
"state": "MN",
"postal_code": "565375505",
"telephone_number": "218-736-6987",
"fax_number": "218-736-0734"
}
],
"practiceLocations": [
{
"address_1": "1010 32nd Ave S",
"address_purpose": "LOCATION",
"city": "Moorhead",
"state": "MN",
"postal_code": "565605001",
"country_code": "US",
"telephone_number": "218-233-7524",
"fax_number": "218-233-8627",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "928 8th St SE",
"address_purpose": "LOCATION",
"city": "Detroit Lakes",
"state": "MN",
"postal_code": "565012839",
"country_code": "US",
"telephone_number": "218-847-1676",
"fax_number": "218-847-1678",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "14 6th Ave NW",
"address_purpose": "LOCATION",
"city": "Glenwood",
"state": "MN",
"postal_code": "563341160",
"country_code": "US",
"telephone_number": "320-634-3446",
"fax_number": "320-634-0384",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "702 34th Ave E",
"address_purpose": "LOCATION",
"city": "Alexandria",
"state": "MN",
"postal_code": "563082599",
"country_code": "US",
"telephone_number": "320-762-2400",
"fax_number": "320-762-8047",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "LAKELAND MENTAL HEALTH CENTER, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-03",
"last_updated": "2021-09-20",
"certification_date": "2021-09-20",
"status": "A",
"authorized_official_last_name": "BAKER",
"authorized_official_first_name": "DONNA",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "218-299-6669",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": "MN",
"license": "434755200",
"primary": false
},
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": "MN",
"license": "434755211",
"primary": false
},
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": "MN",
"license": "434755212",
"primary": false
},
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": "MN",
"license": "801338-1-MHC",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "434755212",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIME WEST HEALTH SYSTEM",
"identifier": "030701035",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "250357300",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "434755211",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE MINNESOTA",
"identifier": "109513",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "434755200",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF MINNESOTA",
"identifier": "62522LA",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fergus Falls, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; 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.