Healthcare Provider Details

I. General information

NPI: 1063336949
Provider Name (Legal Business Name): INDEPENDENT SCHOOL DISTRICT #38
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23990 HIGHWAY 1 EAST
RED LAKE MN
56671-0000
US

IV. Provider business mailing address

PO BOX 499
RED LAKE MN
56671-0499
US

V. Phone/Fax

Practice location:
  • Phone: 218-679-3353
  • Fax:
Mailing address:
  • Phone: 218-679-3353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DANIELLE NORBY KONDZIOLKA
Title or Position: MH PROGRAM DEVELOPMENT CONSULTANT
Credential: MSW, LICSW
Phone: 218-203-9698