GAIL MATTOCKS (NPI# 1275032690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275032690 |
| Entity Type | Individual |
| Full Name | GAIL MATTOCKS |
| Credential | LADC |
| Practice Address |
713 Anderson Ave Saint Cloud MN 56303-2048 |
| Mailing Address |
1406 6th Ave N Saint Cloud MN 56303-1900 |
| Practice Telephone | 3202293760 |
| Practice Fax Number | 3202293764 |
| Mailing Telephone | 3202512700 |
| Mailing Fax Number | 3206567009 |
| Enumeration Date | 2018-02-12 |
| Last Update Date | 2018-02-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
302584 | MN | Behavioral Health & Social Service Providers |
| Street Address |
713 ANDERSON AVE |
| City | SAINT CLOUD |
| State | MN |
| Zip Code | 56303-2048 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407406754 | Paula Pick Weathers | Counselor | 713 Anderson Ave, Saint Cloud, MN 56303-2048 | 2019-09-18 |
| 1346807393 | Adam Thiel | Counselor | 713 Anderson Ave, Saint Cloud, MN 56303-2048 | 2019-05-24 |
| 1992361885 | Jacqueline Mary Wruck | Counselor | 713 Anderson Ave, Saint Cloud, MN 56303-2048 | 2019-05-15 |
| 1972065928 | Jon M Holthusen | Counselor | 713 Anderson Ave, Saint Cloud, MN 56303-2048 | 2019-04-01 |
| 1750842241 | Jeremy Taylor Krentz | Counselor | 713 Anderson Ave, Saint Cloud, MN 56303-2048 | 2019-03-27 |
| 1942704036 | Steve Lungstrom | Counselor | 713 Anderson Ave, Saint Cloud, MN 56303-2048 | 2018-03-22 |
| 1710481262 | Amber Kay Swanson | Counselor | 713 Anderson Ave, Saint Cloud, MN 56303-2048 | 2018-03-20 |
| 1467615294 | St. Cloud Hospital | Rehabilitation, Substance Use Disorder Unit | 713 Anderson Ave, Saint Cloud, MN 56303-2048 | 2008-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800463 | Daniel P Lahr | Radiologic Technologist | St Cloud Va Health Care System, 4801 Veterans Drive, St Cloud, MN 56303 | 2020-08-07 |
| 1730798398 | County of Stearns | Case Management | 705 Courthouse Square, St Cloud, MN 56303 | 2020-07-29 |
| 1669007126 | Aflah Transportation LLC | Non-emergency Medical Transport (VAN) | 3316 3rd Street North, Suite 129, Saint Cloud, MN 56303 | 2020-03-05 |
| 1609420942 | Stephanie Lynne Metzger | Nurse Practitioner | Centracare Clinic Riverc Ampus/nephrology, 1200 Sixth Ave North, St. Cloud, MN 56303 | 2019-07-25 |
| 1306406947 | Willow Tree Acupuncture LLC | Acupuncturist | 203 Cooper Ave N Suite 160, St. Cloud, MN 56303 | 2019-06-17 |
| 1821553520 | Alan Melvin Hoeper | Nurse Anesthetist, Certified Registered | Centracare Clinic Anesthesiology, 3701 12th St N, Suite 202, St. Cloud, MN 56303 | 2019-02-06 |
| 1437644465 | Brianna Larissa Justin | Speech-Language Pathologist | St. Cloud Hospital, 1406 6th Avenue N, St. Cloud, MN 56303 | 2018-06-22 |
| 1780186486 | Simplicity Health Pa | Family Medicine | 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 | 2018-03-08 |
| 1639682925 | Dereje Beyene | Respiratory Therapist, Certified | 1406 15th Street North, Saint Cloud, MN 56303 | 2017-11-09 |
| 1740792761 | Lisa Ann Horner | Nurse Practitioner | 1555 Northway Drive #110, Centracare Complex Care Clinic, St Cloud, MN 56303 | 2017-10-31 |
| Find all providers in zip 56303 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841799657 | Jake Toratti | Counselor | 1572 County Road 134, Saint Cloud, MN 56303-0346 | 2018-02-07 |
| 1063927911 | Jennifer Anderson | Counselor | 524 25th Ave N, Saint Cloud, MN 56303-3255 | 2017-12-13 |
| 1922409648 | S.b. Consulting L.L.C. | Counselor | 1030 4th St Se, Saint Cloud, MN 56304-1215 | 2014-09-12 |
| 1821405820 | Daniel Rueckert | Counselor | 1425 E Saint Germain St, Saint Cloud, MN 56304-0617 | 2014-07-22 |
| 1316362734 | Saundra Laidlaw | Counselor | 529 16th Ave N, Saint Cloud, MN 56303-3954 | 2014-02-21 |
| 1215279187 | Jennifer Walker | Counselor | 1204 7th St S Ste 105, Saint Cloud, MN 56301-4285 | 2013-03-19 |
| 1194957522 | William Leslie Weber-brown | Counselor | 227 10th Ave N, Saint Cloud, MN 56303-4637 | 2009-08-19 |
| 1689810293 | Mary Jane Tolmaoff | Counselor | 2763 Shannin Dr, Saint Cloud, FL 34771-8708 | 2009-01-02 |
| 1386766426 | Central Minnesota Mental Health Center | Counselor | 3220 8th Street North, Saint Cloud, MN 56303-3128 | 2007-04-06 |
| 1124133475 | Effective Living Center, Inc | Counselor | 821 W Saint Germain St, Saint Cloud, MN 56301-3515 | 2006-08-20 |
| Find all providers in SAINT CLOUD | ||||
| City | SAINT CLOUD |
| Zip Code | 56303 |
Please comment or provide details below to improve the information on GAIL MATTOCKS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.