| Northstar Community Services Llc | |
|
30 N 10 Th St. Cloquet MN 55720 | |
| (218) 626-5175 | |
| (218) 879-2696 |
| Full Name | Northstar Community Services Llc |
|---|---|
| Speciality | Social Worker |
| Location | 30 N 10 Th St., Cloquet, Minnesota |
| Authorized Official Name and Position | Heather Lea Wright (PRESIDENT) |
| Authorized Official Contact | 2186265175 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northstar Community Services Llc Po Box 189 Cloquet MN 55720 Ph: (218) 626-5175 | Northstar Community Services Llc 30 N 10 Th St. Cloquet MN 55720 Ph: (218) 626-5175 |
| NPI Number | 1740938430 |
|---|---|
| Provider Enumeration Date | 03/13/2022 |
| Last Update Date | 05/17/2024 |
| Certification Date | 05/17/2024 |
| Medicare PECOS PAC ID | 6204297286 |
|---|---|
| Medicare Enrollment ID | O20230808000131 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740938430 | NPI | - | NPPES |
| 1508626250 | Other | MN | MEGAN ROBINSON, OTR/L NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| 225X00000X | Occupational Therapist | (* (Not Available)) | Secondary |
| Provider Name | Heather Lea Wright |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215405063 PECOS PAC ID: 7012378094 Enrollment ID: I20231116003465 |
| Provider Name | Paige M Konrad |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467859637 PECOS PAC ID: 0244675213 Enrollment ID: I20240229001284 |
| Provider Name | Courtney Haviland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063018919 PECOS PAC ID: 0446781470 Enrollment ID: I20241002000381 |
| Provider Name | Ari Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356193288 PECOS PAC ID: 1355870262 Enrollment ID: I20250122001750 |
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