KWST TARGETED BEHAVIORAL DEVELOPMENT GROUP (NPI# 1376151977) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376151977 |
| Entity Type | Organization |
| Organization Name | KWST TARGETED BEHAVIORAL DEVELOPMENT GROUP |
| Practice Address |
333 Washington Ave N Ste 332 Minneapolis MN 55401-1366 |
| Practice Telephone | 6125186009 |
| Mailing Telephone | 6125186009 |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2020-07-20 |
| Authorized Official Name | KEARY WAYNE SAFFOLD (PRESIDENT) |
| Authorized Official Telephone | 6125186009 |
| Authorized Official Credential | MED |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers | ||
| N | 172V00000X | Community Health Worker | Other Service Providers | ||
| N | 261QS1000X |
Clinic/Center Specialization: Student Health |
Ambulatory Health Care Facilities | ||
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
333 WASHINGTON AVE N STE 332 |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55401-1366 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316410012 | Janessa Angelica Beebe | Counselor | Cornerstone Therapy and Recovery Center, 1600 University Avenue West Suite #203, St. Paul, MN 55401 | 2019-01-04 |
| 1144706094 | Adrienne Sharma | Psychologist | 708 North 1st Street, Suite #242, Minneapolis, MN 55401 | 2018-07-13 |
| 1023511904 | Angela Perriman Dogins | Nurse Practitioner | 100 Washington Avenue South, Suite 900, Minneaplois, MN 55401 | 2018-03-16 |
| 1962924472 | Accuquest Hearing Centers, LLC | Clinic/Center | 2620 Steward Ave., Suite 114, Wausau, WI 55401 | 2017-07-17 |
| 1699186932 | Ross Schilling | Chiropractor | 250 2nd Avenue South, 286, Minneapolis, MN 55401 | 2014-05-08 |
| 1548516974 | Minnesota International Middle School | Local Education Agency (LEA) | 227 12th Ave N, Minneapolis, MN 55401 | 2012-08-03 |
| 1194919316 | Lynn Spaw | Nurse Practitioner | 333 Washington Avenue S, Suite 5000, Minneapolis, MN 55401 | 2007-08-30 |
| 1811947500 | Daniel Warren Eurman | Radiology | 100 3rd Ave S Unit 1507, Minneapolis, MN 55401 | 2006-05-11 |
| 1215928015 | Virginia Karen Vaughn | Nurse Practitioner | Minuteclinic 333 Washington Ave. North, Suite 5000, Minneapolis, MN 55401 | 2005-10-31 |
| 1447550876 | Walter Lee Bailey | Neurological Surgery | 500 River St, Minneapolis, MN 55401 | 2010-11-02 |
| Find all providers in zip 55401 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134596075 | Lauren Nicole Kranig | Case Manager/Care Coordinator | 2445 Park Ave, Minneapolis, MN 55404-3714 | 2015-08-26 |
| 1467857052 | Abdi Jama | Case Manager/Care Coordinator | 1912 Stevens Ave Apt 308, Minneapolis, MN 55403-3883 | 2014-10-26 |
| 1326489691 | Amy E Rock | Case Manager/Care Coordinator | 3208 W Lake St # 102, Minneapolis, MN 55416-4512 | 2013-07-15 |
| 1386960698 | Sarah Hook | Case Manager/Care Coordinator | 1508 E Franklin Ave, Minneapolis, MN 55404-2157 | 2010-04-12 |
| 1700113214 | Dianne Mckenzie | Case Manager/Care Coordinator | 1309 Girard Ave N, Minneapolis, MN 55411-3128 | 2009-11-05 |
| 1982738555 | Sharlene Mae Walczak | Case Manager/Care Coordinator | 2003 Central Ave Ne, Minneapolis, MN 55418-4531 | 2007-03-15 |
| 1457983124 | Tara Marie Stevens | Case Manager/Care Coordinator | 2445 Park Ave, Minneapolis, MN 55404-3714 | 2020-02-10 |
| 1518599281 | Brittany Mae Fisher | Case Manager/Care Coordinator | 2445 Park Ave, Minneapolis, MN 55404-3714 | 2020-02-10 |
| 1568092062 | Renzo Mikolaj Junius Sauer | Case Manager/Care Coordinator | 3333 University Ave Se, Minneapolis, MN 55414-3325 | 2020-01-23 |
| 1700358090 | Ann Marie Crosby | Case Manager/Care Coordinator | 2400 W 64th St, Minneapolis, MN 55423-1001 | 2018-12-26 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55401 |
Please comment or provide details below to improve the information on KWST TARGETED BEHAVIORAL DEVELOPMENT GROUP.
| 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.