Central Lakes Mental Health

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

CENTRAL LAKES MENTAL HEALTH

Practice address

1103 Broadway St Ste 102
Alexandria, MN 56308-0015

Phone

(320) 228-9903

Fax

(320) 238-7406

NPI assigned

Jul 19, 2020

Organization subpart

No

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

Authorized official

Name

Erica Leigh Overshiner, LICSW

Title

Owner/Counselor

Phone

(320) 228-9903

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1595116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595116800000",
    "number": "1689282378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 BROADWAY ST STE 102",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563080015",
            "telephone_number": "320-228-9903",
            "fax_number": "320-238-7406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 BROADWAY ST STE 102",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563080015",
            "telephone_number": "320-228-9903",
            "fax_number": "320-238-7406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL LAKES MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-19",
        "last_updated": "2020-07-19",
        "certification_date": "2020-07-19",
        "status": "A",
        "authorized_official_last_name": "OVERSHINER",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "OWNER/COUNSELOR",
        "authorized_official_telephone_number": "320-228-9903",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gayle Lee Chamberlin, DC BS
• Alison F Chinn, M.D.
• Chippewa Solutions LLC

• Clinical Social Worker in Alexandria, MN
• Providers in Alexandria, 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 Jul 19, 2020; 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.