OTTERSON MENTAL HEALTH SERVICES INC (NPI# 1659611341) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659611341 |
| Entity Type | Organization |
| Organization Name | OTTERSON MENTAL HEALTH SERVICES INC |
| Practice Address |
324 West Superior Street Suite 505 Duluth MN 55802 |
| Practice Telephone | 2187403061 |
| Practice Fax Number | 2187403044 |
| Mailing Telephone | 2187403061 |
| Mailing Fax Number | 2187403044 |
| Enumeration Date | 2013-02-18 |
| Last Update Date | 2013-02-18 |
| Authorized Official Name | TROY DAVID OTTERSON (OWNER/PRESIDENT) |
| Authorized Official Telephone | 2187403061 |
| Authorized Official Credential | MSW, LICSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
18201 | MN | Behavioral Health & Social Service Providers |
| Street Address |
324 WEST SUPERIOR STREET SUITE 505 |
| City | DULUTH |
| State | MN |
| Zip Code | 55802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457519571 | Frank L Wolf Md Pa | Surgery | 324 West Superior Street, Suite 1025, Duluth, MN 55802-1777 | 2008-05-27 |
| 1215306089 | Laurie Jane Beyer | Social Worker | 324 West Superior Street, Suite #505, Duluth, MN 55802-1725 | 2015-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063915239 | Jpw Counseling & Consultation | Social Worker | 302 W Superior St Ste 508, Duluth, MN 55802 | 2018-03-14 |
| 1134664311 | Amp Group, LLC | Counselor | 331 West Superior Street, Duluth, MN 55802 | 2016-12-27 |
| 1982151361 | Tiffany Riester | Counselor | 332 W Superior Street, Suite 300, Duluth, MN 55802 | 2016-09-02 |
| 1730635392 | Karina Krosbakken | Counselor | 332 W. Superior St., Suite 300, Duluth, MN 55802 | 2016-09-01 |
| 1437559051 | Natalie R Zwak | Dietitian, Registered | 26 E Superior St Ste 315, Duluth, MN 55802 | 2014-09-02 |
| 1447679279 | Valerie Lou Shelton | Registered Nurse | 118 E Superior St., Duluth, MN 55802 | 2014-04-09 |
| 1285063115 | Brian Bergstedt | Counselor | 332 West Superior Street, Suite 300, Duluth, MN 55802 | 2013-11-01 |
| 1508135948 | Karen Dee Turner | Counselor | 202 W. Superior Street, Suite 700, Duluth, MN 55802 | 2011-12-14 |
| 1497023410 | Jean Barrie Mcbride | Pharmacist | 1131 East Superior Street, Duluth, MN 55802 | 2011-12-05 |
| 1194092304 | Diane Murphy Winship | Pharmacist | 1331 Superior St, Duluth, MN 55802 | 2011-11-17 |
| Find all providers in zip 55802 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497366611 | Harvest Moon Mental Health Services, LLC | Social Worker | 1509 E Superior St Apt 203, Duluth, MN 55812-4402 | 2020-08-11 |
| 1235756784 | Allissa Rardin | Social Worker | 720 N Central Ave, Duluth, MN 55807-1305 | 2020-07-01 |
| 1245701044 | Kathryn Irene Vaughn | Social Worker | 3968 Mainsail Court, Duluth, GA 30096 | 2018-12-06 |
| 1063915239 | Jpw Counseling & Consultation | Social Worker | 302 W Superior St Ste 508, Duluth, MN 55802 | 2018-03-14 |
| 1205348372 | Viloria C Jackson | Social Worker | 3611 Gray Pl, Duluth, GA 30096-3298 | 2017-10-30 |
| 1992225668 | Splady Therapy Services, LLC | Social Worker | 205 W 2nd St Ste 421, Duluth, MN 55802-1920 | 2017-06-23 |
| 1568999308 | Jim Gaylord | Social Worker | 6208 E Superior St, Duluth, MN 55804-2542 | 2017-05-11 |
| 1962860940 | Devon Maycock | Social Worker | 1027 N 8th Ave E, Duluth, MN 55805-1427 | 2016-02-04 |
| 1457718744 | Matheny Therapy & Consulting, LLC | Social Worker | 5241 N Shore Dr, Duluth, MN 55804-2911 | 2016-01-18 |
| 1689044620 | Mari Trine | Social Worker | 2421 London Rd, Duluth, MN 55812-2222 | 2015-10-02 |
| Find all providers in DULUTH | ||||
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| 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.