North Central Ministry Development Center, Inc.
NPI 1164711735ActiveOrganization· Psychologist, Counseling· New Brighton, MN
Psychologist, Counseling in New Brighton, Minnesota, registered in NPPES in April 2011. The authorized official on file is Mark Elmer Sundby, PH.D., Executive Director. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1164711735 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 4, 2011 |
| Last updated in NPPES | May 14, 2025 |
| Certified by provider | May 14, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Counseling Primary | 103TC1900X | LP4114 | MN |
| Psychologist, Clinical | 103TC0700X | LP4223 | MN |
| Psychologist, Counseling | 103TC1900X | LP0816 | MN |
| Psychologist, Counseling | 103TC1900X | LP5213 | MN |
| Social Worker, Clinical | 1041C0700X | MN06627 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MN) |
|---|
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