NPIMap

Organization Active NPI

Refractions LLC

  • Professional Counselor
  • Saint Augusta, MN
National Provider Identifier
1407356710
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
00597 Issued in MN
Legal business name
REFRACTIONS LLC
Practice address
22575 43Rd Ave
Saint Augusta, MN 56301-8729
Phone
(320) 223-1161
NPI assigned
Feb 14, 2018
Last updated
Apr 1, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Authorized official

Name
Molly Corene Pena
Title
Owner
Phone
(320) 252-6017

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 00597 MN Primary
Mental Illness Community Based Residential Treatment Facility 320800000X NU

Addresses

Primary practice location

22575 43Rd Ave
Saint Augusta, MN 56301-8729

Mailing address

22575 43Rd Ave
Saint Augusta, MN 56301-8729
Phone (320) 223-1161

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1518566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554076800000",
    "number": "1407356710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22575 43RD AVE",
            "city": "SAINT AUGUSTA",
            "state": "MN",
            "postal_code": "563018729",
            "telephone_number": "320-223-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22575 43RD AVE",
            "city": "SAINT AUGUSTA",
            "state": "MN",
            "postal_code": "563018729",
            "telephone_number": "320-223-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REFRACTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-14",
        "last_updated": "2019-04-01",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "MOLLY",
        "authorized_official_middle_name": "CORENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-252-6017"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "00597",
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Augusta, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2019; 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.