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24D2178337 CLIA NUMBER - NYSTROM AND ASSOCIATES

Laboratory Demographics

CLIA Number: 24D2178337

Facility Name: NYSTROM AND ASSOCIATES

Facility Address:
207 JEFFERSON BLVD
BIG LAKE, MN
ZIP 55309
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Facility Phone Number: 651 628-9566

Facility Type: Comp. Outpatient Rehab Facility

Certificate Type: Waiver
NPI Number: 1396750188

Taxonomy: 1041C0700X - Social Worker
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

CLIA Record

Field Name Field Value
CLIA Number 24D2178337
LAB Type Comp. Outpatient Rehab Facility
Facility Name NYSTROM AND ASSOCIATES
Street 207 JEFFERSON BLVD
City BIG LAKE
State MN
ZIP 55309
Phone 651 628-9566
CertificateType 4
CertificateEffectiveDate 1/31/2024
CertificateExpirationDate 1/30/2026
FacilityType Waiver

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This page was last updated on: 4/23/2024