MINNESOTA STATE UNIVERSITY MOORHEAD (NPI# 1932540127) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932540127 |
| Entity Type | Organization |
| Organization Name | MINNESOTA STATE UNIVERSITY MOORHEAD |
| Other Organization Name | COMMUNITY OUTREACH CENTER |
| Practice Address |
113 Lommen 1104 7th Ave S Moorhead MN 56563-1013 |
| Practice Telephone | 2184772506 |
| Mailing Telephone | 2184772506 |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2013-07-16 |
| Authorized Official Name | BENJAMIN LEE ERIE (CLINIC COORDINATOR) |
| Authorized Official Telephone | 2184772506 |
| Authorized Official Credential | LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| Y | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Community Outreach Center | Other Name - Individual/Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MINNESOTA STATE UNIVERSITY MOORHEAD | 1104 7th Ave S, Moorhead, MN 56563-0002 |
| Street Address |
113 LOMMEN 1104 7TH AVE S |
| City | MOORHEAD |
| State | MN |
| Zip Code | 56563-1013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346658549 | Charles Meek | Specialist/Technologist | Minnesota State University Moorhead, Nemzek Hall Room 125, Moorhead, MN 56563 | 2014-07-31 |
| 1073648259 | Allan James Luistro | Family Medicine | 1104 7th Ave S., Box 92 Msum Hendrix Clinic & Counseling Center, Moorhead, MN 56563 | 2007-02-21 |
| 1356378848 | Keith Allen Wiedrich | Specialist/Technologist | 1107 7th St. S., Msu Moorhead - Athletics, Moorhead, MN 56563 | 2006-06-28 |
| 1235103284 | Ronda K Peterson | Specialist/Technologist | 125 Nemzek, Msum, Moorhead, MN 56563 | 2006-02-15 |
| 1124092176 | Andrea Lynn Scott | Specialist/Technologist | Nemzek 125, Minnesota State University Moorhead, Moorhead, MN 56563 | 2006-02-15 |
| 1891906202 | Joni K Mehrhoff | Speech-Language Pathologist | 1104 7th Ave South, Moorhead, MN 56563 | 2007-05-25 |
| 1982162434 | Family Health Care Center | Clinic/Center | 1104 7th Ave S # 92, Moorhead, MN 56563-0001 | 2019-03-04 |
| 1659688034 | Maribeth Kay Plankers | Speech-Language Pathologist | 1104 7th Avenue South, Msum, Moorhead, MN 56563-0001 | 2010-09-08 |
| 1700119351 | Elaine K. Pyle | Speech-Language Pathologist | 1104 7th Ave. South, Msum Box 119, Moorhead, MN 56563-0001 | 2009-09-15 |
| 1073605697 | Bruce R Hanson | Speech-Language Pathologist | 1104 7th Ave South, Msum Box 119, Moorhead, MN 56563-0001 | 2006-09-29 |
| Find all providers in zip 56563 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467947291 | Melissa Dahl | Counselor | 1602 Belsly Blvd, Moorhead, MN 56560-5285 | 2018-06-25 |
| 1538466263 | Kathryn Taylor Wayt | Counselor | 2901 20th St S, Moorhead, MN 56560-5269 | 2011-02-15 |
| 1184237620 | Britni Kay Joubert | Counselor | 815 37th Ave S, Moorhead, MN 56560-5524 | 2020-08-25 |
| 1942834429 | Nicole Annette Ogan | Counselor | 1132 28th Ave S, Moorhead, MN 56560-4420 | 2020-02-24 |
| 1699315838 | Sarah Ann Connell | Counselor | 1132 28th Ave S Ste 102, Moorhead, MN 56560-4420 | 2020-01-15 |
| 1538668355 | Kelsi Mcclaflin | Counselor | 815 37th Ave S, Moorhead, MN 56560-5524 | 2018-02-07 |
| 1437662970 | Eben Blake Danielson | Counselor | 815 37th Ave S, Moorhead, MN 56560-5524 | 2017-11-07 |
| 1053823955 | Christina J Fike | Counselor | 2405 8th St S Ste 200, Moorhead, MN 56560-4224 | 2017-10-31 |
| 1326575903 | Hannah Marie Pederson | Counselor | 815 37th Ave S, Moorhead, MN 56560-5524 | 2017-05-15 |
| 1295266831 | Jonathan Berntson | Counselor | 891 Belsly Blvd, Moorhead, MN 56560-5055 | 2017-03-24 |
| Find all providers in MOORHEAD | ||||
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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.