MINNESOTA RECOVERY CONNECTION (NPI# 1821556614) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821556614 |
| Entity Type | Organization |
| Organization Name | MINNESOTA RECOVERY CONNECTION |
| Practice Address |
2446 University Ave W Ste 112 Saint Paul MN 55114-1740 |
| Practice Telephone | 6125844158 |
| Practice Fax Number | 6128863940 |
| Mailing Telephone | 6125844158 |
| Mailing Fax Number | 6128863940 |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2019-03-11 |
| Authorized Official Name | TIFFANY DA'SHAY IRVIN (MANAGER OF PEER SERVICES) |
| Authorized Official Telephone | 6513211100 |
| Authorized Official Credential | CPRS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Other Name | Type Code |
|---|---|
| Minnesota Recovery Connection | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MINNESOTA RECOVERY CONNECTION | 2446 University Ave W Ste 112, Saint Paul, MN 55114-1740 |
| Street Address |
2446 UNIVERSITY AVE W STE 112 |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55114-1740 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790205698 | Der Yang | Registered Nurse | 2356 University Ave W #220, Saint Paul, MN 55114 | 2017-06-21 |
| 1679949358 | Mallory Haglund | Counselor | 284 West Rocky Lane, Boulder, NV 55114 | 2015-08-17 |
| 1083090880 | Kayla Estenson | Marriage & Family Therapist | 2324 University Ave West, 120, St. Paul, MN 55114 | 2015-08-04 |
| 1184023772 | Preetanjali Thakur | Dentist | 2550 University Avenue West Suite 189s, St Paul, MN 55114 | 2014-08-19 |
| 1023426210 | Melanie Bayer Witthoft | Social Worker | 762 Transfer Road, 21, St. Paul, MN 55114 | 2014-07-31 |
| 1184046518 | Britni Kelley | Marriage & Family Therapist | 821 Raymond Ave Ste 325, Saint Paul, MN 55114 | 2014-01-21 |
| 1205257581 | Arti Kaul | Dentist | 808 Berry St, Apy 126, St Paul, MN 55114 | 2014-01-03 |
| 1588907109 | Jesus M Calvillo | Counselor | 821 Raymond Ave Ste 230, Saint Paul, MN 55114 | 2013-04-02 |
| 1154669414 | Caringhands Home Health Care Inc. | Home Health | 2233 University Ave West, Suite 330, St Paul, MN 55114 | 2013-01-22 |
| 1396021424 | The Avalon Charter School | Local Education Agency (LEA) | 700 Glendale Street, Saint Paul, MN 55114 | 2011-11-03 |
| Find all providers in zip 55114 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477152767 | Sara Eigenheer | Peer Specialist | 600 25th Ave S Ste 104, Saint Cloud, MN 56301-4820 | 2020-10-19 |
| 1225636459 | Melanie Joann Wettstein | Peer Specialist | 5027 Evergreen Dr N Unit 3, Hugo, MN 55038-8578 | 2020-10-10 |
| 1184274904 | Twin Cities Recovery Project Inc | Peer Specialist | 3400 E Lake St, Minneapolis, MN 55406-2150 | 2019-09-13 |
| 1720527872 | Kerry Leno | Peer Specialist | 1132 28th Ave S Ste 102, Moorhead, MN 56560-4420 | 2017-02-21 |
| 1265890073 | Miles Hamlin-zamojski | Peer Specialist | 3800 Aldrich Ave S, Apt 2, Minneapolis, MN 55409-1027 | 2016-02-08 |
| 1992347694 | Peter Green | Peer Specialist | 3400 E Lake St, Minneapolis, MN 55406-2150 | 2019-10-14 |
| 1083256002 | Lauren A Foster | Peer Specialist | 117 W James St, Paynesville, MN 56362-1216 | 2019-10-10 |
| 1780248807 | Sue Ann Stewart | Peer Specialist | 112 Highway 371 S, Hackensack, MN 56452-2638 | 2019-04-24 |
| 1669036968 | Luann Gravelle | Peer Specialist | 112 Highway 371 S, Hackensack, MN 56452-2638 | 2019-04-23 |
| 1285197756 | Beyond Brink | Peer Specialist | 314 Chestnut St, Mankato, MN 56001-3032 | 2019-04-10 |
| Find all providers with the same taxonomy | ||||
| City | SAINT PAUL |
| Zip Code | 55114 |
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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.