EVERNORTH CLINIC PLLC NPI 1053116483

NPI Information

  • NPI: 1053116483
  • Provider Name: EVERNORTH CLINIC, PLLC
  • Classification: Clinic/Center - 261QM0855X
  • Specialization: Adolescent and Children Mental Health
  • Entity Type: Organization
  • Address: 5703 LACHMAN AVE NE
    ALBERTVILLE, MN
    ZIP 55301
  • Phone: (763) 284-1877

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NPI Details

EVERNORTH CLINIC, PLLC is an adolescent and children mental health clinic center in Albertville, MN. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. EVERNORTH CLINIC, PLLC NPI is 1053116483. The provider is registered as an organization entity type.

The provider's business location address is:

5703 LACHMAN AVE NE
ALBERTVILLE, MN
ZIP 55301-973
Phone: (763) 284-1877
Fax: (763) 205-5834

The provider's authorized official is Amanda Johnson .
The authorized official title is Owner, Founder and has the following contact phone number (931) 436-8197.

The enumeration date for this NPI number is 2/18/2025 and was last updated on 10/6/2025.

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
1261QM0855XClinic/CenterAdolescent and Children Mental HealthYes

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: 11/21/2025

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