Mental Health Unliminted

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

18010 Issued in MN

Legal business name

MENTAL HEALTH UNLIMINTED

Practice address

6053 Hudson Rd
Ste 150
Woodbury, MN 55125-1015

Phone

(952) 451-1547

NPI assigned

Apr 20, 2011

Organization subpart

No

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

Authorized official

Name

Jamison Wayne Ottum, MS

Title

Psychotherapist/Clinic Director

Phone

(952) 451-1547

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1303257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303776000000",
    "number": "1659662971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6053 HUDSON RD",
            "address_2": "STE 150",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251015",
            "telephone_number": "952-451-1547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6053 HUDSON RD",
            "address_2": "STE 150",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251015",
            "telephone_number": "952-451-1547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH UNLIMINTED",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-20",
        "last_updated": "2011-04-26",
        "status": "A",
        "authorized_official_last_name": "OTTUM",
        "authorized_official_first_name": "JAMISON",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST/CLINIC DIRECTOR",
        "authorized_official_telephone_number": "952-451-1547",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "18010",
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN MEDICAL ASSISTANCE",
            "identifier": "1659506525",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOTHERAPIST",
            "identifier": "1740440015",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Almaz Fesehaye Melake
• James A. Meland, PH.D., L.P.
• Danielle Mendenhall, P.T.A
• Mayra Quitzia Mendoza Batista
• Jodie Lynn Mensink, AUD CCC A
• Anna Marie Menter
• Michelle M Mercado
• Rachel Catherine Mergens
• Merit Spine LLC
• Marty Thomas Mertens, M.D.

• Clinical Social Worker in Woodbury, MN
• Providers in Woodbury, 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 Apr 26, 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.