Healthcare Provider Details

I. General information

NPI: 1558215210
Provider Name (Legal Business Name): NORTHERN TRANSFORMATIONS P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2026
Last Update Date: 09/11/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1802 CLOQUET AVE
CLOQUET MN
55720-1616
US

IV. Provider business mailing address

14051 BURNHAVEN DR STE 103
BURNSVILLE MN
55337-4400
US

V. Phone/Fax

Practice location:
  • Phone: 612-429-1011
  • Fax:
Mailing address:
  • Phone: 844-642-2735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JOANNAH BLUNTACH
Title or Position: PMHNP
Credential: APRN, CNP
Phone: 218-969-1347