1. Home
  2. Directory
  3. Minnesota
  4. Cloquet
  5. Clinic Center
  6. NPI Profile

FDL ADOLESCENT OUTPATIENT TX
NPI 1447606959
Clinic/Center - Adolescent and Children Mental Health in Cloquet, MN

Active since May 13, 2016
927 TRETTEL LN, CLOQUET, MN 55720(218) 879-1227 Get Directions Write a Review

NPPES record last updated: October 10, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 10, 2016, May 13, 2016 (2 updates tracked since 2016).

About Fdl Adolescent Outpatient Tx NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FDL ADOLESCENT OUTPATIENT TX (NPI 1447606959), doing business as Fond Du Lac Reservation Business Committee, is a healthcare organization registered as an adolescent and children mental health in Cloquet, Minnesota and active in the NPI registry since May 2016. The organization lists Marilyn Grover, Associate Director, as its authorized official.

NPPES Registry Identity

NPI1447606959
Entity TypeOrganization
Primary Taxonomy261QM0855X
Legal Business NameFDL ADOLESCENT OUTPATIENT TX
Location Address927 TRETTEL LNCloquet, MN 55720-1345
Mailing Address927 Trettel LnCloquet, MN 55720-1345
Phone(218) 879-1227
Organization SubpartYesParent: Fond Du Lac Human Services Division
Authorized OfficialMarilyn GroverAssociate Director · (218) 879-1227
Enumeration DateMay 13, 2016
Last NPPES UpdateOctober 10, 20162 updates tracked since enumeration
✔ NPI 1447606959 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Adolescent and Children Mental HealthAmbulatory Health Care Facilities
Taxonomy Code261QM0855X
Definition
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.
927 TRETTEL LN, Cloquet, MN 55720
Open in Google Maps ↗

Other Names 1

Former Legal Business NameFond Du Lac Reservation Business Committee

Other Identifiers 5

Medicaid666815101MN
Medicaid666815100MN
Other8F27F0MN · Bcbs Aoda
Medicare NSC5985000001MN
Medicare PINC06351MN

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. ARNE VAINIO MD
Family Medicine
927 TRETTEL LN
CLOQUET, MN 55720
Carlton County (218) 879-1227
TAYLOR BECKENBACH LMFT
Marriage & Family Therapist
927 TRETTEL LN
CLOQUET, MN 55720
Carlton County (218) 879-1227
KEVIN RANDA LPCC
Counselor (Professional)
927 TRETTEL LN
CLOQUET, MN 55720
Carlton County (218) 879-1227
KARI STROIK LICSW
Social Worker (Clinical)
927 TRETTEL LN
CLOQUET, MN 55720
Carlton County (218) 879-1227
MRS. KIRSTEN MARIE KORTESMA NP
Nurse Practitioner (Family)
927 TRETTEL LN
CLOQUET, MN 55720
Carlton County (218) 879-1227
FOND DU LAC RESERVATION BUSINESS COMMITTEE
Clinic/Center (Mental Health (Including Community Mental Health Center))
927 TRETTEL LN
CLOQUET, MN 55720
Carlton County (218) 879-1227
MS. LEEANNA LYNN STOCK RN, LD, CO
Dietitian, Registered
927 TRETTEL LN
CLOQUET, MN 55720
Carlton County (218) 879-1227
DR. ROBERT ALEXANDER JOHNSON DMD
Dentist
927 TRETTEL LN
CLOQUET, MN 55720
Carlton County (218) 879-1227

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fdl Adolescent Outpatient Tx's NPI number?

The NPI number for Fdl Adolescent Outpatient Tx is 1447606959. It was assigned to this organization in the NPPES registry on May 13, 2016. The provider was formerly known as Fond Du Lac Reservation Business Committee.

Where is Fdl Adolescent Outpatient Tx located?

Fdl Adolescent Outpatient Tx is located at 927 Trettel Ln, Cloquet, MN 55720. The listed phone number is (218) 879-1227.

What is Fdl Adolescent Outpatient Tx's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adolescent and Children Mental Health, with taxonomy code 261QM0855X.

When was this NPI record last updated?

The NPPES record for Fdl Adolescent Outpatient Tx was last updated on October 10, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.