Healthcare Provider Details

I. General information

NPI: 1609930502
Provider Name (Legal Business Name): IND SCHOOL DIST 549
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 CONEY STREET W.
PERHAM MN
56573
US

IV. Provider business mailing address

800 CONEY STREET W.
PERHAM MN
56573
US

V. Phone/Fax

Practice location:
  • Phone: 218-543-4501
  • Fax: 218-346-6504
Mailing address:
  • Phone: 218-543-4501
  • Fax: 218-346-6504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: MITCH ERIC ANDERSON
Title or Position: SUPERINTENDENT
Credential:
Phone: 218-346-4501