Gail Johanna Grogan Pedersen, LICSW | |
1355 Spencer Rd W, Saint Paul, MN 55108-5206 | |
(651) 983-3743 | |
Not Available |
Full Name | Gail Johanna Grogan Pedersen |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 1355 Spencer Rd W, Saint Paul, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1952046294 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 13610 (Minnesota) | Primary |
Entity Name | Brave Choices, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1740637750 PECOS PAC ID: 3072857622 Enrollment ID: O20181207001840 |
Mailing Address | Practice Location Address |
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Gail Johanna Grogan Pedersen, LICSW 1355 Spencer Rd W, Saint Paul, MN 55108-5206 Ph: (651) 983-3743 | Gail Johanna Grogan Pedersen, LICSW 1355 Spencer Rd W, Saint Paul, MN 55108-5206 Ph: (651) 983-3743 |
Mr. Michael Joseph O'neill, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1919 University Ave W, Saint Paul, MN 55104 Phone: 651-266-7900 Fax: 651-266-7850 | |
Ms. Sharon Kay Geiger, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1919 University Ave W, Saint Paul, MN 55104 Phone: 651-266-7978 | |
Mrs. Karen Anne Stevensen, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2469 University Ave W, Saint Paul, MN 55114 Phone: 612-720-5083 | |
Kathleen Lombardi, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1919 University Ave W Ste 200, Saint Paul, MN 55104 Phone: 651-266-7900 | |
Ms. Sherie Lou Bosak, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 821 Raymond Ave, #300, Saint Paul, MN 55114 Phone: 651-645-0438 Fax: 651-647-0659 | |
Helen Jane Gammon, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 640 Jackson St, Saint Paul, MN 55101 Phone: 651-254-2766 | |
Ken Wilfred Schmitz, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2469 University Ave W, Saint Paul, MN 55114 Phone: 651-659-0294 |