Healthcare Provider Details

I. General information

NPI: 1265312607
Provider Name (Legal Business Name): CONTEMPORARY MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15088 22ND AVE NE STE 3
LITTLE FALLS MN
56345-3634
US

IV. Provider business mailing address

32518 RIVER VISTA LN
SAINT CLOUD MN
56303-9564
US

V. Phone/Fax

Practice location:
  • Phone: 320-429-7535
  • Fax: 320-238-7528
Mailing address:
  • Phone: 320-429-7535
  • Fax: 320-238-7528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JULI SUZANNE BLACK
Title or Position: NURSE PRACTITIONER/OWNER
Credential: APRN, CNP, PMHNP-BC
Phone: 320-429-7535