MEDICARE: WALDHAVEN MENTAL HEALTH PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1083569479
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WALDHAVEN MENTAL HEALTH PLLC

Provider Business Mailing Address
First Line	:	892 ARLINGTON AVE W
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55117-3310
Country	:	US
Telephone Number	:	612-597-2669
Fax Number	:

Provider Business Practice Location Address
First Line	:	892 ARLINGTON AVE W
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55117-3310
Country	:	US
Telephone Number	:	612-597-2669
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	STEVEN LUTES
Credential	:
Telephone Number	:	612-597-2669

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

Similar Medicare Providers

1427652569 — GHENET TEKLE
Practice Location Address:

1312 MISSISSIPPI ST
SAINT PAUL, MN
55130-3310

Practice Phone: 651-434-9669
Practice Fax:

1851489561 — DR. CHRISTOPHER M HAMPSON M.D.
Practice Location Address:

3310 W MAIN ST STE 100
SAINT CHARLES, IL
60175-1024

Practice Phone: 630-366-2180
Practice Fax: 630-668-2195

1821232257 — MRS. DONNA MARIE FREDERICK P.T.
Practice Location Address:

3310 CORDES DR
SAINT LOUIS, MO
63125-4430

Practice Phone: 314-894-3547
Practice Fax:

1043763154 — CARLISSA HARVEY
Practice Location Address:

3310 MERAMEC ST
SAINT LOUIS, MO
63118-4311

Practice Phone: 314-749-0152
Practice Fax: 844-316-0208

1104379114 — GOOD FAITH CONSUMER DIRECTED SERVICES LLC
Practice Location Address:

3310 MERAMEC ST
SAINT LOUIS, MO
63118-4311

Practice Phone: 314-749-0152
Practice Fax: 844-316-0208

1194273300 — WILLIAM DUNN II
Practice Location Address:

8743 S FEDERAL HWY
PORT SAINT LUCIE, FL
34952-3310

Practice Phone: 754-244-7970
Practice Fax:

Directions to “WALDHAVEN MENTAL HEALTH PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.