NPIMap

Organization Active NPI

Northwest Journey - Eau Claire

  • Adolescent and Children Mental Health Clinic/Center
  • Eau Claire, WI
National Provider Identifier
1851418982
Registry record updated Sep 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
2421 Issued in WI
Legal business name
NORTHWEST JOURNEY - EAU CLAIRE
Practice address
3203 Stein Blvd
Eau Claire, WI 54701-6917
Phone
(715) 552-1342
Fax
(715) 552-1644
NPI assigned
Mar 23, 2007
Last updated
Sep 23, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTHWEST COUNSELING AND GUIDANCE CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 23, 2010

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

Authorized official

Name
Mr. Nick Kalambokidis
Title
Cfo
Phone
(715) 327-4402

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 2421 WI Primary

Addresses

Primary practice location

3203 Stein Blvd
Eau Claire, WI 54701-6917

Mailing address

3203 Stein Blvd
Eau Claire, WI 54701-6917
Phone (715) 552-1342

Other identifiers 3

IdentifierTypeStateIssuer
43007400MedicaidWI
85575OtherMNPREFERRED ONE
42626OtherMNHEALTH PARTNERS

National Provider Directory

National Provider Directory
Tax ID family
Northwest CNSL Guid22 organizations share this tax ID, including this one
Part of
Northwest CNSL Guid

Other organizations with this tax ID 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285200000000",
    "number": "1851418982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3203 STEIN BLVD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016917",
            "telephone_number": "715-552-1342",
            "fax_number": "715-552-1644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3203 STEIN BLVD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016917",
            "telephone_number": "715-552-1342",
            "fax_number": "715-552-1644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST JOURNEY - EAU CLAIRE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHWEST COUNSELING AND GUIDANCE CLINIC",
        "enumeration_date": "2007-03-23",
        "last_updated": "2010-09-23",
        "status": "A",
        "authorized_official_last_name": "KALAMBOKIDIS",
        "authorized_official_first_name": "NICK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "715-327-4402",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "WI",
            "license": "2421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43007400",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "85575",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "42626",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2010; 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.