CENTRAL MINNESOTA MENTAL HEALTH CENTER NPI 1780890046

NPI Information

NPI: 1780890046
Provider Name: CENTRAL MINNESOTA MENTAL HEALTH CENTER
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

CLIA Number: 24D2116385

Address:
407 WASHINGTON ST
MONTICELLO, MN
ZIP 55362
Phone: (763) 271-5340
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CENTRAL MINNESOTA MENTAL HEALTH CENTER is a mental health counselor in Monticello, MN. CENTRAL MINNESOTA MENTAL HEALTH CENTER NPI is 1780890046. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

407 WASHINGTON ST
MONTICELLO, MN
ZIP 55362-815
Phone: (763) 271-5340
Fax: (763) 271-5350

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 24D2116385 - other - community mental health c with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/15/2007 and was last updated on 7/21/2008.

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	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	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: 5/5/2024

NPI Synchronization or Removal

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