Northernwaters Counseling LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

NORTHERNWATERS COUNSELING LLC

Practice address

14091 Baxter Dr Ste 112
Baxter, MN 56425-8703

Phone

(218) 296-0632

NPI assigned

Oct 13, 2021

Last updated

Jun 28, 2026By 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

Theresa OddenNPI 1457025439

Title

Owner

Phone

(218) 296-0632

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 2

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.

• Theresa Odden, LPCC

  • Mental Health Counselor
  • Baxter, MN
  • NPI 1457025439
  Medicare reassignment NPD Authorized official
• Tanya Martha Kubista, MA LMFT

  • Marriage & Family Therapist
  • Baxter, MN
  • NPI 1154711406
  NPD

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

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782604800000",
    "number": "1912660259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14091 BAXTER DR STE 112",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258703",
            "telephone_number": "218-296-0632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14091 BAXTER DR STE 112",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258703",
            "telephone_number": "218-296-0632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERNWATERS COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-13",
        "last_updated": "2026-06-28",
        "certification_date": "2026-06-28",
        "status": "A",
        "authorized_official_last_name": "ODDEN",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-296-0632"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Elissa Anne Nygaard
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• Mental Health Clinic/Center (Including Community Mental Health Center) in Baxter, MN
• Providers in Baxter, MN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.