North Shore Community Counseling Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

NORTH SHORE COMMUNITY COUNSELING SERVICES

Practice address

4915 E Superior St
Suite 202
Duluth, MN 55804-2452

Phone

(218) 461-2903

NPI assigned

Aug 5, 2011

Last updated

Aug 5, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Benjamin Matthew Hatfield, MSW, LGSW, LADC

Title

Chief Executive Officer

Phone

(218) 461-2903

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1312502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312502400000",
    "number": "1427337633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4915 E SUPERIOR ST",
            "address_2": "SUITE 202",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558042452",
            "telephone_number": "218-461-2903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 E SUPERIOR ST",
            "address_2": "SUITE 202",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558042452",
            "telephone_number": "218-461-2903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE COMMUNITY COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-05",
        "last_updated": "2011-08-05",
        "status": "A",
        "authorized_official_last_name": "HATFIELD",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "218-461-2903",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW, LGSW, LADC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Duluth, MN
• Providers in Duluth, MN by specialty
• Community/Behavioral Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2011; 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.