NPIMap

Organization Active NPI

Well PLLC

Doing business as Well

  • Mental Health Counselor
  • Grand Rapids, MN
National Provider Identifier
1508336223
Registry record updated Jun 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
WELL PLLC
Doing business as
Well
Practice address
801 NE 4TH St
Grand Rapids, MN 55744-3106
Phone
(218) 398-0742
NPI assigned
Nov 26, 2018
Last updated
Jun 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2020

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

Authorized official

Name
James Dale ChristianNPI 1548699986
Title
Therapist/ Co-Owner
Phone
(218) 999-9660

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

801 NE 4TH St
Grand Rapids, MN 55744-3106

Mailing address

801 NE 4TH St
Grand Rapids, MN 55744-3106
Phone (218) 999-9660

Other names 1

  • Well Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190117002500 MN Part B Supplier - Clinic/Group Practice 6800132416 Receives reassigned benefits from 4 practitioners
Practice locations: Grand Rapids, MN

National Provider Directory

National Provider Directory

Locations

801 NE 4th St
Grand Rapids, MN 55744
Phone (218) 326-1732

Practitioners & affiliated clinicians

Practitioners 6

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": "1543190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590969600000",
    "number": "1508336223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 NE 4TH ST",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443106",
            "telephone_number": "218-999-9660",
            "fax_number": "218-999-7560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 NE 4TH ST",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443106",
            "telephone_number": "218-398-0742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-26",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A",
        "authorized_official_last_name": "CHRISTIAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "THERAPIST/ CO-OWNER",
        "authorized_official_telephone_number": "218-999-9660"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Well",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2020; 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.