Provider Demographics
NPI:1093422727
Name:UPNORTH MENTAL HEALTH L.L.C
Entity Type:Organization
Organization Name:UPNORTH MENTAL HEALTH L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AMMIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:218-766-5133
Mailing Address - Street 1:49269 317TH AVE
Mailing Address - Street 2:
Mailing Address - City:CASS LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:56633-2996
Mailing Address - Country:US
Mailing Address - Phone:218-766-5133
Mailing Address - Fax:
Practice Address - Street 1:1900 DIVISION ST W UNIT 6
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-6397
Practice Address - Country:US
Practice Address - Phone:218-766-5133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-02
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty