Effective Living Center, Inc

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

804331-2-CDT Issued in MN

Legal business name

EFFECTIVE LIVING CENTER, INC

Practice address

103 6TH St NE
Little Falls, MN 56345-2854

Phone

(320) 632-3166

Fax

(320) 632-3297

NPI assigned

Aug 21, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Colleen Walker-Stedham, MS, LSW, LPC

Title

President

Phone

(320) 632-3166

Specialties & licenses 1

Addresses

Tax ID family

Effective Living Center Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Effective Living Center, Inc

  • Addiction (Substance Use Disorder) Counselor
  • Saint Cloud, MN
  • NPI 1124133475
  NPD tax ID
• Effective Living Center, Inc

  • Community/Behavioral Health Agency
  • Saint Cloud, MN
  • NPI 1538488721
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Leslie Marie Sandy, LICSW. LADC

  • Clinical Social Worker
  • Little Falls, MN
  • NPI 1003589557

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750496295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 6TH ST NE",
            "city": "LITTLE FALLS",
            "state": "MN",
            "postal_code": "563452854",
            "telephone_number": "320-632-3166",
            "fax_number": "320-632-3297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 6TH ST NE",
            "city": "LITTLE FALLS",
            "state": "MN",
            "postal_code": "563452854",
            "telephone_number": "320-632-3166",
            "fax_number": "320-632-3297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EFFECTIVE LIVING CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALKER-STEDHAM",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "320-632-3166",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, LSW, LPC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "804331-2-CDT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael J Dorle, MD
• Kristin Doucette, APRN, PMHNP
• Richard Dunning, DO
• Nicole A Ebnet, PHARMD
• David Earl Edgerton Jr., D.O.
• Daniel Enderlin, D.P.M.
• Falls Court Dentists PA
• Falls Optical, Inc.
• Family Chiropractic Center of Little Falls, P.a.
• FCSL Little Falls, LLC

• Addiction (Substance Use Disorder) Counselor in Little Falls, MN
• Providers in Little Falls, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.