PRAIRIE ST. JOHN'S CLINIC NPI 1073601258

NPI Information

NPI: 1073601258
Provider Name: PRAIRIE ST. JOHN'S CLINIC
Classification: Clinic/Center - 261QM0855X
Specialization: Adolescent and Children Mental Health
Entity Type: Organization
Address: 7616 CURRELL BLVD
SUITE 100
WOODBURY, MN
ZIP 55125
Phone: (651) 259-9700

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NPI Details

PRAIRIE ST. JOHN'S CLINIC is an adolescent and children mental health clinic center in Woodbury, 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. PRAIRIE ST. JOHN'S CLINIC NPI is 1073601258. The provider is registered as an organization entity type.

The provider's business location address is:

7616 CURRELL BLVD
SUITE 100
WOODBURY, MN
ZIP 55125-290
Phone: (651) 259-9700
Fax: (651) 259-9740

The provider's authorized official is Jerry W Magnison .
The authorized official title is Chief Financial Officer and has the following contact phone number (701) 476-7221.

The enumeration date for this NPI number is 10/11/2006 and was last updated on 8/22/2020.

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	261QM0855X	Clinic/Center	Adolescent and Children Mental Health	5063A	NORTH DAKOTA	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	238T5PR	OTHER	MINNESOTA	MINNESOTA BLUE CROSS

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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