Professional Recovery Organization LLC
NPI 1639715402ActiveOrganization· Counselor, Professional· Woodbury, MN
Counselor, Professional in Woodbury, Minnesota, registered in NPPES in November 2019. The authorized official on file is Lauren Fortman, MA LPCC LADC, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1639715402 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 26, 2019 |
| Last updated in NPPES | Mar 19, 2024 |
| Certified by provider | Mar 19, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor, Professional Primary | 101YP2500X | — | — |
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 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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