TIA DVORAK (NPI# 1912383969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912383969 |
| Entity Type | Individual |
| Full Name | TIA DVORAK |
| Credential | MS LMFT |
| Practice Address |
9201 Quaday Ave Ne Ste 250 Otsego MN 55330-6602 |
| Mailing Address |
9201 Quaday Ave Ne Otsego MN 55330-6602 |
| Practice Telephone | 7637036962 |
| Practice Fax Number | 6512229727 |
| Mailing Telephone | 7637036962 |
| Mailing Fax Number | 6512229727 |
| Enumeration Date | 2015-07-31 |
| Last Update Date | 2019-06-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
2822 | MN | Behavioral Health & Social Service Providers |
| Y | 106H00000X | Marriage & Family Therapist | 2822 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 2822 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 16016 233rd St, Little Falls, MN 563455583 | 3206325524 | 8889912741 |
| Street Address |
9201 QUADAY AVE NE STE 250 |
| City | OTSEGO |
| State | MN |
| Zip Code | 55330-6602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710504139 | Jacob Stevens | Pharmacist | 19216 Freeport Ave, Cub Pharmacy, Elk River, MN 55330 | 2020-07-01 |
| 1578187456 | Coborns Inc | Pharmacy | 15700 88th St Ne, Otsego, MN 55330 | 2020-06-05 |
| 1346888609 | Katie Eberley | Counselor | 9425 Quantrelle Ave, Otsego, MN 55330 | 2019-12-18 |
| 1649839986 | Jodi Marie Pikula | Massage Therapist | 710 Dodge Ave, Suite C, Elk River, MN 55330 | 2019-06-11 |
| 1144793878 | Northern Cities Therapy, Inc. | Counselor | 19230 Evans St Nw Ste 100, Elk River, MN 55330 | 2019-01-04 |
| 1144715236 | Jennifer Kay Dahlseid | Chiropractor | 200 5th St Nw Ste J, Elk River, MN 55330 | 2018-06-29 |
| 1124542089 | Megan Majsterski Lazere | Counselor | 9245 Quantrelle Avenue, Otsego, MN 55330 | 2017-08-01 |
| 1134674237 | Rescare Minnesota | Community Based Residential Treatment Facility, Mental Illness | 633 Upland Ave Nw, Elk River, MN 55330 | 2016-08-18 |
| 1356894927 | Allison Benz | Counselor | 9245 Quantrelle Ave, Otsego, MN 55330 | 2016-07-29 |
| 1447615141 | Laura Stevenson | Speech-Language Pathologist | 15990 90th St., Otsego, MN 55330 | 2015-12-22 |
| Find all providers in zip 55330 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821465154 | Hannah Driver | Marriage & Family Therapist | 16201 90th St Ne Ste 100, Otsego, MN 55330-7466 | 2015-08-21 |
| 1790033371 | Jennifer Marie Doeden | Marriage & Family Therapist | 9201 Quaday Ave Ne Ste 205, Otsego, MN 55330-6604 | 2012-08-29 |
| 1295036119 | Barbara B Cuppett | Marriage & Family Therapist | 9000 Quantrelle Ave Ne, Otsego, MN 55330-0139 | 2010-11-09 |
| 1437558814 | Leah Corder | Marriage & Family Therapist | 9201 Quaday Ave Ne Ste 205, Otsego, MN 55330 | 2014-08-21 |
| 1609115757 | Olena Ruchko | Marriage & Family Therapist | 16201 90th St Ne, Suite 200, Otsego, MN 55330-7463 | 2013-02-10 |
| 1952662611 | Melodie Illies | Marriage & Family Therapist | 16201 90th St Ne, Suite 200, Otsego, MN 55330-7463 | 2012-05-30 |
| 1093854945 | Jane Pollock Johnson | Marriage & Family Therapist | 9245 Quantrelle Ave Ne, Otsego, MN 55330-0168 | 2007-02-06 |
| 1942378302 | Sandra Louis Mangle | Marriage & Family Therapist | 9075 Quaday Ave Ne, Suite 102, Otsego, MN 55330-6672 | 2006-12-01 |
| 1467474197 | John William Eskola | Marriage & Family Therapist | 9075 Quaday Ave Ne, Suite 102, Otsego, MN 55330-6653 | 2006-07-24 |
| 1104842459 | Lisa Anne Eskola | Marriage & Family Therapist | 9245 Quantrelle Ave Ne, Otsego, MN 55330-0168 | 2006-07-13 |
| Find all providers in OTSEGO | ||||
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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.