Corrine Ann Poole, MSW, LICSW | |
4500 Park Glen Rd Ste 450, Saint Louis Park, MN 55416-5190 | |
(952) 444-9744 | |
Not Available |
Full Name | Corrine Ann Poole |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 4500 Park Glen Rd Ste 450, Saint Louis Park, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1992295059 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 24315 (Minnesota) | Primary |
Entity Name | Wild Tree Psychotherapy Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1528451408 PECOS PAC ID: 8426408881 Enrollment ID: O20231227001431 |
Mailing Address | Practice Location Address |
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Corrine Ann Poole, MSW, LICSW 277 Deubener Pl, Saint Paul, MN 55105-3201 Ph: (920) 569-9565 | Corrine Ann Poole, MSW, LICSW 4500 Park Glen Rd Ste 450, Saint Louis Park, MN 55416-5190 Ph: (952) 444-9744 |
Debra Jean Waite, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 5100 Gamble Dr, Suite 100 Mail Stop 31200a, Saint Louis Park, MN 55416 Phone: 952-593-8777 Fax: 952-595-6408 | |
Elaina Marie Vig, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3947 Excelsior Blvd Ste 110, Saint Louis Park, MN 55416 Phone: 763-222-5327 | |
Mr. Noah Julian Simcox, LICSW Clinical Social Worker Medicare: May Accept Medicare Assignments Practice Location: 4021 Vernon Ave S Ste 306, Saint Louis Park, MN 55416 Phone: 651-646-2326 | |
Kendra M Olson, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 3800 Park Nicollet Blvd, 3rd Floor North, Mental Health, Saint Louis Park, MN 55416 Phone: 952-993-3300 | |
Bhargavi Shiledar Baxi Ghate, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 5009 Excelsior Blvd, Suite 134, Saint Louis Park, MN 55416 Phone: 612-360-5685 | |
Robert Joseph Mccauley, MSW, MED, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 715 Florida Ave S Ste 307, Saint Louis Park, MN 55426 Phone: 952-544-6806 Fax: 952-545-0098 | |
Jamielee Brown, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1351 Idaho Ave S, Saint Louis Park, MN 55426 Phone: 763-600-3176 |