Northway Academy, Inc.
Northway Academy, Inc. is a healthcare organization registered as Developmental Disabilities Clinic/Center in Saint Cloud, MN, holding Type 2 (organization) NPI 1104333715 since 2018. The authorized official on file is Mary Rodenberg-Roberts, Vice Pres & Sr. Asst Gc.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1104333715 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Northway Academy, Inc. |
| Other name | <Unavail> |
| Practice address | 108 DOCTORS PARK, Saint Cloud, MN, 56303 |
| Phone | 3202596022 |
| Fax | 9529226885 |
| Enumeration date | 2018-01-04 |
| Last updated in NPPES | 2024-01-23 |
Authorized official
| Name | Mary Rodenberg-Roberts |
|---|---|
| Title | Vice Pres & Sr. Asst Gc |
| Phone | 9528362234 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health Agency | Secondary | — | — |
| 261QD1600X | Developmental Disabilities Clinic/Center | Primary | — | — |
Copy-ready billing details
Provider: Northway Academy, Inc. NPI: 1104333715 Taxonomy: 261QD1600X (Developmental Disabilities Clinic/Center) Address: 108 DOCTORS PARK, Saint Cloud, MN, 56303
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1710459748 | Avery Harrison | Individual | Behavior Technician | Saint Cloud, MN |
| 1508339565 | Susan Stang | Individual | Behavior Technician | Saint Cloud, MN |
| 1437622487 | Hannah Planinsheck | Individual | Behavior Technician | Saint Cloud, MN |
| 1386117323 | Belinda Labor | Individual | Behavior Technician | Saint Cloud, MN |
| 1306319363 | Mackenzie Tadych | Individual | Behavior Technician | Saint Cloud, MN |
| 1992278956 | Dalton Yocum | Individual | Behavior Technician | Saint Cloud, MN |
| 1205309259 | Samantha Ommodt | Individual | Behavior Technician | Saint Cloud, MN |
| 1861965899 | Dustin Johnson | Individual | Behavior Technician | Saint Cloud, MN |
Verify this record
Cross-check NPI 1104333715 against the authoritative CMS record: view Northway Academy, Inc. on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What type of organization is Northway Academy, Inc.?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2024-01-23.