Organization Active NPI

White Pine Mental Health

  • Mental Health Counselor
  • Houlton, WI
National Provider Identifier
1871392589
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
WHITE PINE MENTAL HEALTH
Practice address
1330 39TH St
Houlton, WI 54082-1500
Phone
(612) 219-4048
NPI assigned
Mar 13, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Authorized official

Name
Katrina Jean Rude, LPCCNPI 1891186847
Title
Owner
Phone
(612) 219-4048

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

1330 39TH St
Houlton, WI 54082-1500

Mailing address

1330 39TH St
Houlton, WI 54082-1500
Phone (612) 219-4048

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250807003436 MN Part B Supplier - Clinic/Group Practice 2466950613 Receives reassigned benefits from 1 practitioner
Practice locations: White Bear Lake, MN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1741824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741824000000",
    "number": "1871392589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 39TH ST",
            "city": "HOULTON",
            "state": "WI",
            "postal_code": "540821500",
            "telephone_number": "612-219-4048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 39TH ST",
            "city": "HOULTON",
            "state": "WI",
            "postal_code": "540821500",
            "telephone_number": "612-219-4048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE PINE MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-13",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A",
        "authorized_official_last_name": "RUDE",
        "authorized_official_first_name": "KATRINA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-219-4048",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houlton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; 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.