NPIMap

Organization Active NPI

Myhealth for Teens & Young Adults

  • Community Health Clinic/Center
  • Hopkins, MN
National Provider Identifier
1386951317
Registry record updated Dec 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
MYHEALTH FOR TEENS & YOUNG ADULTS
Practice address
15 Eighth Ave. S.
Hopkins, MN 55343-7667
Phone
(952) 474-3251
Fax
(952) 767-0815
NPI assigned
Sep 13, 2010
Last updated
Dec 22, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2016

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

Authorized official

Name
Megan Lichty
Title
Director of Admin. & Ops.
Phone
(952) 767-0928

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X NU Primary

Addresses

Primary practice location

15 Eighth Ave. S.
Hopkins, MN 55343-7667

Mailing address

15 Eighth Ave. S.
Hopkins, MN 55343-7667
Phone (952) 474-3251

Other identifiers 3

IdentifierTypeStateIssuer
438964600OtherMNMINNESOTA HEALTH CARE PROGRAM
984772OtherMNUNITED HEALTHCARE
OAF89WEOtherMNBLUECROSS BLUESHIELD

Other names 1

  • West Suburban Teen Clinic Former legal business name

National Provider Directory

National Provider Directory

Locations

15 8th Ave S
Hopkins, MN 55343
Phone (952) 474-3251

Practitioners & affiliated clinicians

Practitioners 9

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": "1284336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482364800000",
    "number": "1386951317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 EIGHTH AVE. S.",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553437667",
            "telephone_number": "952-474-3251",
            "fax_number": "952-767-0815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 EIGHTH AVE. S.",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553437667",
            "telephone_number": "952-474-3251",
            "fax_number": "952-767-0815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYHEALTH FOR TEENS & YOUNG ADULTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-13",
        "last_updated": "2016-12-22",
        "status": "A",
        "authorized_official_last_name": "LICHTY",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "DIRECTOR OF ADMIN. & OPS.",
        "authorized_official_telephone_number": "952-767-0928"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA HEALTH CARE PROGRAM",
            "identifier": "438964600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "984772",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "OAF89WE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Suburban Teen Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Hopkins, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2016; 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.