| Northernwaters Counseling Llc | |
|
14091 Baxter Dr Ste 112 Baxter MN 56425-8703 | |
| (218) 296-0632 | |
| Not Available |
| Full Name | Northernwaters Counseling Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 14091 Baxter Dr Ste 112, Baxter, Minnesota |
| Authorized Official Name and Position | Theresa Odden (OWNER) |
| Authorized Official Contact | 2182960632 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northernwaters Counseling Llc 14091 Baxter Dr Ste 112 Baxter MN 56425-8703 Ph: (218) 296-0632 | Northernwaters Counseling Llc 14091 Baxter Dr Ste 112 Baxter MN 56425-8703 Ph: (218) 296-0632 |
| NPI Number | 1912660259 |
|---|---|
| Provider Enumeration Date | 10/13/2021 |
| Last Update Date | 06/28/2026 |
| Certification Date | 06/28/2026 |
| Medicare PECOS PAC ID | 2264875640 |
|---|---|
| Medicare Enrollment ID | O20240213003112 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912660259 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Theresa Odden |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457025439 PECOS PAC ID: 8022451400 Enrollment ID: I20240213002984 |
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