| Northern Psychiatric Associates | |
|
7115 Forthun Rd Suite 105 Baxter MN 56425-8597 | |
| (218) 454-0090 | |
| (218) 454-0091 |
| Full Name | Northern Psychiatric Associates |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 7115 Forthun Rd, Baxter, Minnesota |
| Authorized Official Name and Position | Elliot Richelson (DIRECTOR, PRESIDENT, SECRETARY, AND) |
| Authorized Official Contact | 9046054986 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Psychiatric Associates 7115 Forthun Rd Suite 105 Baxter MN 56425-8597 Ph: (218) 454-0090 | Northern Psychiatric Associates 7115 Forthun Rd Suite 105 Baxter MN 56425-8597 Ph: (218) 454-0090 |
| NPI Number | 1083725147 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 03/15/2023 |
| Certification Date | 03/15/2023 |
| Medicare PECOS PAC ID | 7517998222 |
|---|---|
| Medicare Enrollment ID | O20050823000356 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083725147 | NPI | - | NPPES |
| 503580500 | Medicaid | MN | |
| 55A48AN | Other | MN | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | David C Anderholm |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528039682 PECOS PAC ID: 4880623206 Enrollment ID: I20050805000741 |
| Provider Name | Jeanne M Kurtz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760544423 PECOS PAC ID: 9133133168 Enrollment ID: I20060130000486 |
| Provider Name | Melissa A Virnig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558379974 PECOS PAC ID: 3375549652 Enrollment ID: I20061030000485 |
| Provider Name | Shannon M Torborg |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669627972 PECOS PAC ID: 7517101181 Enrollment ID: I20130920000591 |
| Provider Name | Julie M Christensen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407258387 PECOS PAC ID: 5395061311 Enrollment ID: I20150310000027 |
| Provider Name | Casey Wagner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740777838 PECOS PAC ID: 2466717012 Enrollment ID: I20180531001082 |
| Provider Name | Lara L Royer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063887370 PECOS PAC ID: 6901148089 Enrollment ID: I20190422002495 |
| Provider Name | Heather Arbaney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174141956 PECOS PAC ID: 2860811700 Enrollment ID: I20200928000372 |
| Provider Name | Jessica Eastman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780274563 PECOS PAC ID: 6406262591 Enrollment ID: I20210316001152 |
| Provider Name | Nicolle Hagen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477038560 PECOS PAC ID: 4183095458 Enrollment ID: I20230124002154 |
| Provider Name | Jenifer Diane Emmrich Budnick |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1033676580 PECOS PAC ID: 8820432024 Enrollment ID: I20240215002089 |
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