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Organization

CENTRAL MINNESOTA MENTAL HEALTH CENTER

Active
Other names
CMMHC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DAVID J. BARAGA PH.D., LP (EXECUTIVE DIRECTOR)
(320) 252-5010
Entity
Organization

Contact information

Practice address
1321 13TH ST N, SAINT CLOUD, MN 56303-2613
(320) 252-5010
(320) 203-1855
Mailing address
1321 13TH ST N, SAINT CLOUD, MN 56303-2613
(320) 252-5010
(320) 203-1855

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1022869-1-CDT
MN
101YA0400X
Addiction (Substance Use Disorder) Counselor
800357-1-CDT
MN
101YA0400X
Addiction (Substance Use Disorder) Counselor
800832-2-CDT
MN
101YA0400X
Addiction (Substance Use Disorder) Counselor
804852-1-DS
MN
101YA0400X
Addiction (Substance Use Disorder) Counselor
807286-3-CDT
MN
101YA0400X
Addiction (Substance Use Disorder) Counselor
809836-2-CDT
MN
101YM0800X
Mental Health Counselor
Primary
800356-1-MHC
MN
320800000X
Mental Illness Community Based Residential Treatment Facility
809140-1-RMI
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
024755300
MN
05
024755301
MN
05
127824000
MN
05
233650200
MN
05
492319700
MN
05
664725100
MN
05
676555600
MN
05
742698400
MN
05
764442600
MN
Enumeration date
01/06/2006
Last updated
05/27/2009
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