Elijah Wood, DSW, MSW, LICSW | |
15265 Carrousel Way Ste 100, Rosemount, MN 55068-1760 | |
(952) 443-4600 | |
Not Available |
Full Name | Elijah Wood |
---|---|
Gender | Male |
Speciality | Social Worker - Clinical |
Location | 15265 Carrousel Way Ste 100, Rosemount, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1235831322 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 28914 (Minnesota) | Primary |
Entity Name | Lorenz Clinic Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1982900510 PECOS PAC ID: 7810282845 Enrollment ID: O20160830000081 |
Mailing Address | Practice Location Address |
---|---|
Elijah Wood, DSW, MSW, LICSW 15265 Carrousel Way Ste 100, Rosemount, MN 55068-1760 Ph: () - | Elijah Wood, DSW, MSW, LICSW 15265 Carrousel Way Ste 100, Rosemount, MN 55068-1760 Ph: (952) 443-4600 |
Ashley Utz, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 15265 Carrousel Way, Rosemount, MN 55068 Phone: 952-443-4600 Fax: 952-443-4604 | |
Ms. Brittany Dale Leitch Johnson, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 15265 Carrousel Way, Rosemount, MN 55068 Phone: 952-443-4600 Fax: 952-443-4604 | |
Andrea Barlass, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 15265 Carrousel Way Ste 100, Rosemount, MN 55068 Phone: 951-443-4600 | |
Mr. James Gary Ciemny Jr., LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 13531 Athena Way, Rosemount, MN 55068 Phone: 651-322-1143 Fax: 651-683-6819 | |
Kara Marie Haroldson, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 12795 S Robert Trl, Rosemount, MN 55068 Phone: 612-991-3904 | |
Bethany Leanne Bertsch, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 14184 Belfast Ct, Rosemount, MN 55068 Phone: 651-334-1327 |