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NPI Code Detail

MEDICARE: NORTHLAND CHRISTIAN COUNSELING CENTER INC

MEDICARE: NORTHLAND CHRISTIAN COUNSELING CENTER INC
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1215131016
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHLAND CHRISTIAN COUNSELING CENTER INC
Provider Business Mailing Address
First Line : 1615 17TH AVE S
Second Line :
City : GRAND FORKS
State : ND
Zip : 58201-5372
Country : US
Telephone Number : 701-795-8550
Fax Number : 701-746-5523
Provider Business Practice Location Address
First Line : 1615 17TH AVE S
Second Line :
City : GRAND FORKS
State : ND
Zip : 58201-5372
Country : US
Telephone Number : 701-795-8550
Fax Number : 701-746-5523
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : JASON WOOD
Credential : LPCC
Telephone Number : 701-795-8550
Provider Enumeration Date : 06/14/2007
Last Update Date : 01/02/2026

Similar Medicare Providers

1568868545 — AARON A JOHNSEN LPCC
Practice Location Address:
1615 17TH AVE S
GRAND FORKS, ND
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1548770548 — MR. JASON PAUL WOOD LPCC
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1447603832 — SARA LYNNE SUDA LCSW
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GRAND FORKS, ND
58201-5372
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1467657460 — STEPHEN H. SEAY LPCC
Practice Location Address:
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1295372001 — THOMAS WILLIAM SOLEM LPCC, LAC
Practice Location Address:
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Directions to “NORTHLAND CHRISTIAN COUNSELING CENTER INC ” Practice Location

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