Mid-Range Chemical Dependency Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

1061219 Issued in MN

Legal business name

MID-RANGE CHEMICAL DEPENDENCY SERVICES

Practice address

522 E Howard St Ste 101
Hibbing, MN 55746-1714

Phone

(218) 262-0860

NPI assigned

Feb 2, 2012

Organization subpart

No

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

Authorized official

Name

Amanda Clark, LADCNPI 1871027730

Title

Clinical Supervisor

Phone

(218) 262-0860

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amanda Kathaleen Clark, LADC

  • Addiction (Substance Use Disorder) Counselor
  • Hibbing, MN
  • NPI 1871027730
  NPD (past) Authorized official
• Stig Edwardson, LADC

  • Addiction (Substance Use Disorder) Counselor
  • Hibbing, MN
  • NPI 1235736455
  NPD (past)
• Kelly Lockhart, LADC

  • Addiction (Substance Use Disorder) Counselor
  • Hibbing, MN
  • NPI 1205433422
  NPD (past)

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

{
    "created_epoch": "1328140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492473600000",
    "number": "1588936819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 E HOWARD ST STE 101",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "557461714",
            "telephone_number": "218-262-0860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 E HOWARD ST STE 101",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "557461714",
            "telephone_number": "218-262-0860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-RANGE CHEMICAL DEPENDENCY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-02",
        "last_updated": "2017-04-18",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "CLINICAL SUPERVISOR",
        "authorized_official_telephone_number": "218-262-0860",
        "authorized_official_credential": "LADC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "1061219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott A Mescher, O.D.
• Lane Michael Meyer, M.D.
• John Ryan Michaels, DC
• Kristine Elizabeth Michaels, D.C.
• Susan K Michaels, D.C.
• Midwest Optical & Contact Lens Center LLC
• Midwest Vision Centers, Inc
• John David Miettunen, DDS
• Mike Enich Dental PLLC
• Minneapolis Vamc

• Community/Behavioral Health Agency in Hibbing, MN
• Providers in Hibbing, 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 Apr 18, 2017; 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.