East Metro Trauma and Recovery LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

EAST METRO TRAUMA AND RECOVERY LLC

Practice address

4116 Hoffman Rd
White Bear Lake, MN 55110-3708

Phone

(612) 590-4440

Fax

(651) 494-5915

NPI assigned

Oct 28, 2020

Last updated

Jul 21, 2022By 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

Pamela Lynn Graber, LMFTNPI 1326412362

Title

Owner/Ceo

Phone

(612) 590-4440

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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.

• Pamela Lynn Graber, LMFT

  • Marriage & Family Therapist
  • Woodbury, MN
  • NPI 1326412362
  NPD Authorized official

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

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1740880764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8154 ENCLAVE RD",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551253032",
            "telephone_number": "612-590-4440",
            "fax_number": "651-494-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4116 HOFFMAN RD",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103708",
            "telephone_number": "612-590-4440",
            "fax_number": "651-494-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST METRO TRAUMA AND RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-28",
        "last_updated": "2022-07-21",
        "certification_date": "2020-10-28",
        "status": "A",
        "authorized_official_last_name": "GRABER",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "612-590-4440",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF MARRIAGE AND FAMILY THERAPY LICENSING BOARD",
            "identifier": "2672",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "pamgrabertherapy@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8154 Enclave Rd",
            "city": "Woodbury",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551253032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Audrey Elizabeth Dufresne
• Lindsay Duncan
• Dale J Duthoy, MD
• Jessica Dutton, ATC
• Rachel Ann Dwyer
• East West Clinic
• Ann Eckstrom, OTR/L
• Chadaya Eggleston
• Leah Eichmiller, L.AC.
• Jeffrey D Elbers, MD

• Mental Health Clinic/Center (Including Community Mental Health Center) in White Bear Lake, MN
• Providers in White Bear Lake, MN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.