County of Pine

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

Legal business name

COUNTY OF PINE

Doing business as

Pine County Health and Human Services

Practice address

635 Northridge Dr NW Ste 220
Pine City, MN 55063-5984

Phone

(320) 591-1570

Fax

(320) 591-1602

NPI assigned

May 18, 2016

Last updated

Dec 12, 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

Rebecca Foss

Title

Pine County HHS Director

Phone

(320) 216-4104

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Pine County Health and Human Services Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670803200000",
    "number": "1861849978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 NORTHRIDGE DR NW STE 220",
            "city": "PINE CITY",
            "state": "MN",
            "postal_code": "550635984",
            "telephone_number": "320-591-1570",
            "fax_number": "320-591-1602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 NORTHRIDGE DR NW STE 220",
            "city": "PINE CITY",
            "state": "MN",
            "postal_code": "550635984",
            "telephone_number": "320-591-1570",
            "fax_number": "320-591-1602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF PINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-18",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A",
        "authorized_official_last_name": "FOSS",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "PINE COUNTY HHS DIRECTOR",
        "authorized_official_telephone_number": "320-216-4104"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A000058200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE, TYPE UNSPECIFIED",
            "identifier": "908853900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pine County Health and Human Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pine County Health and Human Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Holly Elizabeth Clark, MSW, LICSW
• Bethany Renee Cleary, MA, LPCC
• Kendall Clevenger, PA
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• Bryan Cropper, DOCTOR OF PHARMACY
• Jon E Cruz, DDS
• Clay Macklin Danielson, D.C.
• Mitchell Lee Demers, MSW, LICSW
• Christopher Allen Dockter, DC

• Public Health or Welfare Agency in Pine City, MN
• Providers in Pine City, MN by specialty
• Public Health or Welfare Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.