NORTHWEST JOURNEY - ELLSWORTH NPI 1306965033

NPI Information

  • NPI: 1306965033
  • Provider Name: NORTHWEST JOURNEY - ELLSWORTH
  • Classification: Clinic/Center - 261QM0855X
  • Specialization: Adolescent and Children Mental Health
  • Entity Type: Organization
  • Address: N6096 530TH ST
    ELLSWORTH, WI
    ZIP 54011
  • Phone: (715) 273-0203

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NPI Details

NORTHWEST JOURNEY - ELLSWORTH is an adolescent and children mental health clinic center in Ellsworth, WI. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. NORTHWEST JOURNEY - ELLSWORTH NPI is 1306965033. The provider is registered as an organization entity type.

The provider's business location address is:

N6096 530TH ST
ELLSWORTH, WI
ZIP 54011-107
Phone: (715) 273-0203
Fax: (715) 273-0344

The provider's authorized official is Nick Kalambokidis .
The authorized official title is Cfo and has the following contact phone number (715) 327-4402.

The enumeration date for this NPI number is 3/27/2007 and was last updated on 9/23/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0855XClinic/CenterAdolescent and Children Mental Health2326WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17H956NOOTHERMINNESOTABCBS OF MN
242626OTHERMINNESOTAHEALTH PARTNERS
31306965033OTHERWISCONSINHUMANA
485575OTHERMINNESOTAPREFERRED ONE
543006700MEDICAIDWISCONSIN
61306965033OTHERWISCONSINVALUE OPTIONS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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