Hallie Costello, | |
410 Central Ave N, Faribault, MN 55021-5217 | |
(507) 446-0431 | |
Not Available |
Full Name | Hallie Costello |
---|---|
Gender | Female |
Speciality | Social Worker - Clinical |
Location | 410 Central Ave N, Faribault, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1881345379 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Entity Name | Fernbrook Family Center Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1659483915 PECOS PAC ID: 3870872914 Enrollment ID: O20170531000278 |
Mailing Address | Practice Location Address |
---|---|
Hallie Costello, 2575 Harvest Ln, Owatonna, MN 55060-4305 Ph: (507) 446-0431 | Hallie Costello, 410 Central Ave N, Faribault, MN 55021-5217 Ph: (507) 446-0431 |
Taylor Derosier, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1415 Town Square Ln, Faribault, MN 55021 Phone: 507-323-8100 | |
Mrs. Sadie Elizabeth Watts, MSW, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 625 3rd Ave Nw, Faribault, MN 55021 Phone: 507-720-8011 | |
Mr. David James Rabine-young, MSSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2504 Woodland Dr, Faribault, MN 55021 Phone: 507-334-3992 | |
Maritza Judith Navarro, LGSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1415 Town Square Ln, Faribault, MN 55021 Phone: 507-323-8100 Fax: 833-974-2090 | |
Janine M. Brady, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 303 1st Ave Ne Ste 260, Faribault, MN 55021 Phone: 507-573-1046 | |
Susan M Warring, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 418 Heritage Pl Ste C, Faribault, MN 55021 Phone: 507-301-8677 | |
Lucy Baquero Oja, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 410 Central Ave N, Faribault, MN 55021 Phone: 507-331-3454 |