COMMUNITY OUTREACH COUNSELING PC – Community/Behavioral Health Agency, NPI 1245673482

COMMUNITY OUTREACH COUNSELING PC is a healthcare provider. based in Willmar, Minnesota. specializing in Community/Behavioral Health Agency. The organization holds a License No. 1071 (MN). The NPI Number for COMMUNITY OUTREACH COUNSELING PC is 1245673482

Main info

Organization
Name
COMMUNITY OUTREACH COUNSELING PC
NPI
1245673482
Phone
(320) 905-0795
Address
1617 HIGHWAY 12 E
Authorized Official
MR. TIMOTHY R JOHNSON OWNER MA LMFT
Enumeration Date
8 April 2013
Last Update Date
3 September 2013
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:13State licenses:1Digital endpointsOther names

Provider Addresses for COMMUNITY OUTREACH COUNSELING PC

  • 1617 HIGHWAY 12 E

    SUITE 230

    WILLMAR, MN 562015814

    Phone: (320) 905-0795

    Fax: (320) 205-0030

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-09-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20140925000054OClinic/Group PracticeMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 56201)

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Reviews

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Frequently asked questions

What is COMMUNITY OUTREACH COUNSELING PC's NPI number?
COMMUNITY OUTREACH COUNSELING PC's NPI is 1245673482 — the number used across U.S. healthcare to identify this provider.
Is COMMUNITY OUTREACH COUNSELING PC shown as active in public data?
Registry records indicate COMMUNITY OUTREACH COUNSELING PC maintains an active NPI.
What expertise is attributed to COMMUNITY OUTREACH COUNSELING PC?
COMMUNITY OUTREACH COUNSELING PC's specialty line reads Community/Behavioral Health Agency. Clinical services aligned with this taxonomy classification.
What locale is associated with COMMUNITY OUTREACH COUNSELING PC?
Directory geography for COMMUNITY OUTREACH COUNSELING PC centers on Willmar, Minnesota.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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