Lake Effect Psychotherapy Group LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

LAKE EFFECT PSYCHOTHERAPY GROUP LLC

Practice address

205 W 2ND St Ste 300
Duluth, MN 55802-1920

Phone

(218) 228-0035

Fax

(218) 304-7862

NPI assigned

Nov 13, 2017

Last updated

Nov 13, 2017By 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

Dana Louise Garberg, LICSWNPI 1982977898

Title

Sole Member

Phone

(218) 228-0035

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Dana Louise Garberg, LICSW

  • Clinical Social Worker
  • Duluth, MN
  • NPI 1982977898
  Authorized official Same address or phone

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

{
    "created_epoch": "1510531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510531200000",
    "number": "1649783697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W 2ND ST STE 300",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021920",
            "telephone_number": "218-228-0035",
            "fax_number": "218-304-7862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W 2ND ST STE 300",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021920",
            "telephone_number": "218-228-0035",
            "fax_number": "218-304-7862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE EFFECT PSYCHOTHERAPY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-13",
        "last_updated": "2017-11-13",
        "status": "A",
        "authorized_official_last_name": "GARBERG",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "218-228-0035",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Beth Lagarde, FNP
• Cheryl Lagergren
• Kim Louise Lagro, LICSW
• Sharon Diane Lahti, SLP
• Lake Dental PLLC
• Lake Superior Area Family Services
• Lake Superior College Dental Clinic
• Lake Superior Community Health Center
• Lake Superior Community Health Center
• Lake Superior Community Health Center

• Clinical Social Worker in Duluth, MN
• Providers in Duluth, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.