CENTRAL MINNESOTA MENTAL HEALTH CENTER NPI 1831177195

NPI Information

NPI: 1831177195
Provider Name: CENTRAL MINNESOTA MENTAL HEALTH CENTER

Other Name: CMMHC

Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
1321 13TH ST N
SAINT CLOUD, MN
ZIP 56303
Phone: (320) 252-5010
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CENTRAL MINNESOTA MENTAL HEALTH CENTER is a mental health counselor in Saint Cloud, MN. CENTRAL MINNESOTA MENTAL HEALTH CENTER NPI is 1831177195. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Cmmhc.

The provider's business location address is:

1321 13TH ST N
SAINT CLOUD, MN
ZIP 56303-613
Phone: (320) 252-5010
Fax: (320) 203-1855

The provider's authorized official is David J. Baraga .
The authorized official title is Executive Director and has the following contact phone number (320) 252-5010.

The CLIA number assigned to this NPI record is 24D2279968 - other - mental health psychiatry with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/6/2006 and was last updated on 5/27/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	804852-1-DS	MINNESOTA	No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)	800832-2-CDT	MINNESOTA	No
3	101YA0400X	Counselor	Addiction (Substance Use Disorder)	807286-3-CDT	MINNESOTA	No
4	101YA0400X	Counselor	Addiction (Substance Use Disorder)	809836-2-CDT	MINNESOTA	No
5	101YA0400X	Counselor	Addiction (Substance Use Disorder)	1022869-1-CDT	MINNESOTA	No
6	101YA0400X	Counselor	Addiction (Substance Use Disorder)	800357-1-CDT	MINNESOTA	No
7	320800000X	Community Based Residential Treatment Facility, Mental Illness		809140-1-RMI	MINNESOTA	No
8	101YM0800X	Counselor	Mental Health	800356-1-MHC	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	742698400	MEDICAID	MINNESOTA
2	764442600	MEDICAID	MINNESOTA
3	CO7565	MEDICARE ID-TYPE UNSPECIFIED	MINNESOTA	MEDICARE NUMBER
4	676555600	MEDICAID	MINNESOTA
5	24-4610	MEDICARE ID-TYPE UNSPECIFIED	MINNESOTA	MEDICARE NUMBER
6	024755300	MEDICAID	MINNESOTA
7	127824000	MEDICAID	MINNESOTA
8	233650200	MEDICAID	MINNESOTA
9	664725100	MEDICAID	MINNESOTA
10	492319700	MEDICAID	MINNESOTA
11	024755301	MEDICAID	MINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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