Polk County Social Services

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

POLK COUNTY SOCIAL SERVICES

Practice address

612 N Broadway Ste 110
Crookston, MN 56716-1452

Phone

(218) 281-3127

NPI assigned

Aug 25, 2009

Last updated

Aug 25, 2009By 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. Kent Johnson

Title

Director

Phone

(218) 470-8405

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251158400000",
    "number": "1649403643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 N BROADWAY STE 110",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567161452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 N BROADWAY STE 110",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567161452",
            "telephone_number": "218-281-3127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLK COUNTY SOCIAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-25",
        "last_updated": "2009-08-25",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KENT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "218-470-8405",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Perrone, LADC
• Amber Marie Peterson
• David C Peterson, DPM
• Stephanie Kaitlyn Philyaw
• Polk County Auditor (Polk County Public Health)
• Polk-Norman-Mahnomen Community Health Board
• Prairie Psychological Services PA
• Breanna J. Privratsky, PA-C
• Nicole Qual, D.C.
• Norma Lynette Quam

• Case Management Agency in Crookston, MN
• Providers in Crookston, MN by specialty
• Case Management Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2009; 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.