KASSANDRA KAVANAUGH (NPI# 1922540111) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922540111 |
| Entity Type | Individual |
| Full Name | KASSANDRA KAVANAUGH |
| Credential | M.S. |
| Practice Address |
13045 Falcon Dr Suite 100 Baxter MN 56425-4201 |
| Mailing Address |
1900 Silver Lake Rd Nw Suite 110 New Brighton MN 55112-1786 |
| Practice Telephone | 2188299307 |
| Enumeration Date | 2016-11-06 |
| Last Update Date | 2016-11-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
13045 FALCON DR SUITE 100 |
| City | BAXTER |
| State | MN |
| Zip Code | 56425-4201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346269032 | Donna Sue Peterson | Psychologist | 13045 Falcon Dr, Suite 100, Baxter, MN 56425-4201 | 2006-07-19 |
| 1750947164 | Shelly Jones | Counselor | 13045 Falcon Dr, Baxter, MN 56425-4201 | 2019-05-13 |
| 1316410079 | Sierra Karls | Counselor | 13045 Falcon Dr, Baxter, MN 56425-4201 | 2019-01-05 |
| 1164975793 | Kathryn Moser | Counselor | 13045 Falcon Dr, Suite 100, Baxter, MN 56425-4201 | 2016-08-01 |
| 1306290218 | Alesha Ketter | Counselor | 13045 Falcon Dr, Suite 100, Baxter, MN 56425-4201 | 2016-04-17 |
| 1952795510 | Lori Ann Lachelt | Counselor | 13045 Falcon Dr, Suite 100, Baxter, MN 56425-4201 | 2015-03-22 |
| 1467855155 | Morgen Joray Juel | Psychologist | 13045 Falcon Dr, Suite 100, Baxter, MN 56425-4201 | 2014-10-08 |
| 1841516622 | Michael Joseph Adelman | Psychiatry & Neurology | 13045 Falcon Dr, Suite 100, Baxter, MN 56425-4201 | 2010-04-19 |
| 1942432075 | Rick Wayne Peters | Counselor | 13045 Falcon Dr, Suite 100, Baxter, MN 56425-4201 | 2009-08-24 |
| 1467611657 | Latricia Ann Alt-peters | Nurse Practitioner | 13045 Falcon Dr, Suite 100, Baxter, MN 56425-4201 | 2008-06-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396364089 | Jennifer Ann Olson | Behavioral Analyst | Autism Matters 14387 Edgewood Drive, Baxter, MN 56425 | 2020-04-13 |
| 1801229000 | Longville Lakes Clinic, Inc. | Clinic/Center | 13205 Isle Drive, Baxter, MN 56425 | 2013-08-12 |
| 1033555867 | Shiela Klemmetsen | Family Medicine | Essentia Health St. Joseph's-baxter Clinic, 13060 Isle Drive, Baxter, MN 56425 | 2013-05-20 |
| 1053547299 | Linda Marie Bowman | Social Worker | 13397 Shadow Wood Drive, Baxter, MN 56425 | 2009-06-02 |
| 1215112792 | Brainerd Medical Center, Inc. | Nurse Practitioner | 14133 Edgewood Drive, Baxter, MN 56425 | 2008-01-03 |
| 1134313208 | Sleep Center of Central Minnesota LLC | Clinic/Center | 13495 Elder Drive, Suite 120, Baxter, MN 56425 | 2007-08-31 |
| 1750582482 | Jacqueline Elizabeth Oelfke | Nurse Practitioner | Cbhh-baxter, 14241 Grand Oaks Dr., Baxter, MN 56425 | 2007-05-30 |
| 1508080631 | Five Star Living of Brainerd, LLC | Assisted Living Facility | 14398 Grand Oaks Drive, Baxter, MN 56425 | 2007-04-12 |
| 1093842247 | Five Star Living of Brainerd, LLC | Assisted Living Facility | 14396 Grand Oaks Dr, Baxter, MN 56425 | 2007-02-27 |
| 1053458364 | Teri Kaminski Peterson | Speech-Language Pathologist | 15620 Edgewood Dr Ste 240, Baxter, MN 56425 | 2007-01-30 |
| Find all providers in zip 56425 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164673786 | Brandi Jo Hampshire | Counselor | 166 Rachelle Pl, Baxter, TN 38544-2000 | 2008-10-01 |
| 1598387706 | Christopher W Strahlenbach | Counselor | 13045 Falcon Dr Ste 100, Baxter, MN 56425-4201 | 2020-05-11 |
| 1902360951 | John Allen Blood Jr. | Counselor | 13045 Falcon Dr # 100, Baxter, MN 56425-4201 | 2019-01-24 |
| 1114404274 | Evonne Sirois | Counselor | 13045 Falcon Dr Ste 100, Baxter, MN 56425-4201 | 2018-07-22 |
| 1700371689 | Genevere Ann Smith | Counselor | 13045 Falcon Dr Ste 100, Baxter, MN 56425-4201 | 2018-06-24 |
| 1538651294 | Jessica Andersen | Counselor | 13045 Falcon Dr Ste 100, Baxter, MN 56425-4201 | 2018-05-30 |
| 1376046425 | Wildly Curative | Counselor | 214 Main St, Baxter, TN 38544-5280 | 2018-03-15 |
| 1437658606 | Theodore Robert Hidding | Counselor | 13968 Cypress Dr Ste 1a, Baxter, MN 56425 | 2018-02-02 |
| 1891217980 | Sara Louise Stainbrook | Counselor | 13045 Falcon Dr Ste 100, Baxter, MN 56425-4201 | 2017-07-11 |
| 1164975793 | Kathryn Moser | Counselor | 13045 Falcon Dr, Suite 100, Baxter, MN 56425-4201 | 2016-08-01 |
| Find all providers in BAXTER | ||||
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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.