| Northern Pines Mental Health Center | |
|
1906 5th Ave Se Little Falls MN 56345-3317 | |
| (320) 632-6647 | |
| (320) 632-9525 |
| Full Name | Northern Pines Mental Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1906 5th Ave Se, Little Falls, Minnesota |
| Authorized Official Name and Position | Glenn M Anderson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3206326647 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Pines Mental Health Center Po Box 367 1906 5th Ave Se Little Falls MN 56345-0367 Ph: (320) 632-6642 | Northern Pines Mental Health Center 1906 5th Ave Se Little Falls MN 56345-3317 Ph: (320) 632-6647 |
| NPI Number | 1013904051 |
|---|---|
| Provider Enumeration Date | 10/04/2005 |
| Last Update Date | 05/02/2016 |
| Medicare PECOS PAC ID | 8628979697 |
|---|---|
| Medicare Enrollment ID | O20040114000463 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013904051 | NPI | - | NPPES |
| 83367N0 | Other | MN | BCBS OF MINNESOTA |
| 834755700 | Medicaid | MN | |
| 4788N0 | Other | MN | BCBS OF MINNESOTA |
| 98224 | Other | MN | PREFERRED ONE |
| 007444000 | Medicaid | MN | |
| 126039 | Other | MN | UCARE MINNESOTA |
| 195354100 | Medicaid | MN | |
| 6369 | Other | MN | HEALTH PARTNERS |
| Provider Name | Rosemary B Leonard |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1194866392 PECOS PAC ID: 0648355123 Enrollment ID: I20080307000264 |
| Provider Name | Paul S Springstead |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285793067 PECOS PAC ID: 0143121020 Enrollment ID: I20111114000858 |
| Provider Name | Roxann J Storms |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730527367 PECOS PAC ID: 3779710371 Enrollment ID: I20131205000427 |
| Provider Name | Katy J Srock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790138550 PECOS PAC ID: 7113214172 Enrollment ID: I20160920001124 |
| Provider Name | Andrea L Dalzell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578076154 PECOS PAC ID: 5395003222 Enrollment ID: I20171221002021 |
| Provider Name | Nicole A Rieke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225520851 PECOS PAC ID: 2163772245 Enrollment ID: I20180911002892 |
| Provider Name | Ashley Snyder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043882517 PECOS PAC ID: 8628459559 Enrollment ID: I20220722001795 |
| Provider Name | Kayla Meyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740853522 PECOS PAC ID: 8325423916 Enrollment ID: I20220919000631 |
| Provider Name | Callie Schleicher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164146692 PECOS PAC ID: 6406226927 Enrollment ID: I20221228000467 |
| Provider Name | Kesha L Holst |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255853370 PECOS PAC ID: 3375914351 Enrollment ID: I20230131000395 |
| Provider Name | Shawn R Disterhaupt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942996087 PECOS PAC ID: 8729445986 Enrollment ID: I20230601003090 |
| Provider Name | Christopher Fennema |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689246076 PECOS PAC ID: 7214386457 Enrollment ID: I20231213000497 |
| Provider Name | Matthew Keith Sissons |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710441829 PECOS PAC ID: 6002266475 Enrollment ID: I20231227001744 |
| Provider Name | Elisabeth Ruby |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1609315357 PECOS PAC ID: 9436509494 Enrollment ID: I20240103002158 |
| Provider Name | Justine M Jarmin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417520305 PECOS PAC ID: 5799136800 Enrollment ID: I20240112001143 |
| Provider Name | Ashley Rose Krantz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245570886 PECOS PAC ID: 6800239757 Enrollment ID: I20240207001940 |
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Jessica Rice Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 E Broadway, Little Falls, MN 56345 Phone: 651-402-0701 | |
True Balance Ltd Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 16016 233rd St, Little Falls, MN 56345 Phone: 320-632-5524 Fax: 888-991-2741 | |
Dba Lakes Area Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1906 5th Ave Se, Little Falls, MN 56345 Phone: 320-632-6647 Fax: 320-632-9525 | |
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