Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Northern Waters Clinic

Organization Child & Adolescent Psychiatric/Mental Health Registered Nurse · NPI 1316445455

Northern Waters Clinic is a Child & Adolescent Psychiatric/Mental Health Registered Nurse in Hermantown, Minnesota. Works from 2 locations. Licensed in Minnesota.

Licensed in
MN
In the registry since
2018
Specialties on file
3

Practice location Address checks out

4899 Miller Trunk Hwy Ste 208
Hermantown, MN 55811-1582
Phone: (218) 391-9860
Fax: (218) 391-9860
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1702 Miller Trunk Hwy Ste 214, Duluth, MN 55811-4443 — (218) 391-9860

Specialties & licences

Mental Health Clinic/Center (Including Community Mental Health Center) (primary) Taxonomy 261QM0801X
Child & Adolescent Psychiatric/Mental Health Registered Nurse Taxonomy 163WP0807X · Licence 2318 (MN)
Psychiatric/Mental Health Registered Nurse Taxonomy 163WP0808X · Licence 2318 (MN)

Record details

NPI number1316445455
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Melissa Maki — Co-Owner · (218) 727-3888
Other names Northern Waters Clinic
NPI enumeratedJanuary 23, 2018
Last updated in NPPESDecember 4, 2025
Certification dateDecember 4, 2025
Mailing address1702 Miller Trunk Hwy Ste 214, Duluth, MN 55811-4448