Organization Active NPI

Northeastern Mental Health Center

  • Mental Health Counselor
  • Aberdeen, SD
National Provider Identifier
1801964952
Registry record updated Feb 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
NORTHEASTERN MENTAL HEALTH CENTER
Doing business as
Northeastern Mental Health Center
Practice address
14 S Main St
Suite 1E
Aberdeen, SD 57401-4136
Phone
(605) 225-1010
Fax
(605) 225-1017
NPI assigned
Nov 30, 2006
Last updated
Feb 6, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2026

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

Authorized official

Name
Liza Jo Thares
Title
Financial Specialist
Phone
(605) 725-4953

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
Counselor 101Y00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X Primary
Professional Counselor 101YP2500X
School Counselor 101YS0200X
Social Worker 104100000X
Clinical Social Worker 1041C0700X
School Social Worker 1041S0200X
Marriage & Family Therapist 106H00000X
Psychiatry Physician 2084P0800X

Addresses

Primary practice location

14 S Main St
Suite 1E
Aberdeen, SD 57401-4136

Mailing address

14 S Main St Ste 1E
Aberdeen, SD 57401-4189
Phone (605) 225-1010

Other identifiers 7

IdentifierTypeStateIssuer
5200030MedicaidSD
5261030MedicaidSD
5255030MedicaidSD
9236729OtherSDDAKOTACARE
CP7629OtherSDRAILROAD MEDICARE
5256030MedicaidSD
0000108OtherSDBCBS WELLMARK

Other names 1

  • Northeastern Mental Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031201000100 SD Part B Supplier - Clinic/Group Practice 0446155816 Receives reassigned benefits from 16 practitioners
Practice locations: Aberdeen, SD

National Provider Directory

National Provider Directory

Locations

14 S Main St
Ste 1E
Aberdeen, SD 57401
Phone (605) 225-1010

628 Circle Dr
Aberdeen, SD 57401
Phone (605) 225-1010

703 3rd Ave SE
Aberdeen, SD 57401
Phone (605) 225-1010

9 3rd Ave E
Mobridge, SD 57601
Phone (605) 845-2941

Practitioners & affiliated clinicians

Practitioners 136

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.

View all 136

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770336000000",
    "number": "1801964952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 S MAIN ST STE 1E",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574014189",
            "telephone_number": "605-225-1010",
            "fax_number": "605-225-1017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 S MAIN ST",
            "address_2": "SUITE 1E",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574014136",
            "telephone_number": "605-225-1010",
            "fax_number": "605-225-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEASTERN MENTAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2026-02-06",
        "certification_date": "2026-02-06",
        "status": "A",
        "authorized_official_last_name": "THARES",
        "authorized_official_first_name": "LIZA",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "FINANCIAL SPECIALIST",
        "authorized_official_telephone_number": "605-725-4953"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5200030",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5261030",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5255030",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTACARE",
            "identifier": "9236729",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CP7629",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5256030",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS WELLMARK",
            "identifier": "0000108",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northeastern Mental Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aberdeen, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.