| Northstar Regional | |
|
1045 Stoughton Ave Chaska MN 55318-2149 | |
| (952) 974-3999 | |
| Not Available |
| Full Name | Northstar Regional |
|---|---|
| Speciality | Clinic/Center |
| Location | 1045 Stoughton Ave, Chaska, Minnesota |
| Authorized Official Name and Position | Jason Vanderscoff (CEO) |
| Authorized Official Contact | 6129644312 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northstar Regional 1045 Stoughton Ave Chaska MN 55318-2149 Ph: (952) 448-6557 | Northstar Regional 1045 Stoughton Ave Chaska MN 55318-2149 Ph: (952) 974-3999 |
| NPI Number | 1659764587 |
|---|---|
| Provider Enumeration Date | 03/17/2015 |
| Last Update Date | 10/19/2022 |
| Certification Date | 10/19/2022 |
| Medicare PECOS PAC ID | 8921346669 |
|---|---|
| Medicare Enrollment ID | O20190228000530 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659764587 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Primary |
| Provider Name | Harold A Baumchen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700811866 PECOS PAC ID: 8022072644 Enrollment ID: I20041115000164 |
| Provider Name | Daniel L Snyder |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366477457 PECOS PAC ID: 8820052160 Enrollment ID: I20041116000762 |
| Provider Name | Molly J Stommes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811349004 PECOS PAC ID: 7517253263 Enrollment ID: I20160907001414 |
| Provider Name | Carmen Barnes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689928871 PECOS PAC ID: 1658624309 Enrollment ID: I20181025001672 |
| Provider Name | Jacquelyn Lee Kerkow-dohmen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174186738 PECOS PAC ID: 9830425354 Enrollment ID: I20190722002209 |
| Provider Name | Afton L Steinhoff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164019790 PECOS PAC ID: 9032516471 Enrollment ID: I20210928000064 |
| Provider Name | Brittany Allison Elese Werre |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851050405 PECOS PAC ID: 3274913645 Enrollment ID: I20220630002996 |
| Provider Name | Stephanie Eileen Brey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366070070 PECOS PAC ID: 6305289752 Enrollment ID: I20240213001804 |
| Provider Name | Linda June Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063638427 PECOS PAC ID: 4981055878 Enrollment ID: I20240229002912 |
| Provider Name | Elena Valentynivna Fosness |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1902300783 PECOS PAC ID: 1759726771 Enrollment ID: I20240229003076 |
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