Jennifer Egeland, LICSW | |
5555 Boone Ave N, New Hope, MN 55428-3636 | |
(763) 504-7893 | |
Not Available |
Full Name | Jennifer Egeland |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 5555 Boone Ave N, New Hope, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1083131197 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 22565 (Minnesota) | Primary |
Entity Name | St Croix Psychiatric Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1881849586 PECOS PAC ID: 9335288786 Enrollment ID: O20091125000166 |
Entity Name | Mary Mullenbach Phd Lp Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1801182837 PECOS PAC ID: 5799950283 Enrollment ID: O20111212000760 |
Mailing Address | Practice Location Address |
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Jennifer Egeland, LICSW 16725 12th Ave N, Plymouth, MN 55447-3001 Ph: () - | Jennifer Egeland, LICSW 5555 Boone Ave N, New Hope, MN 55428-3636 Ph: (763) 504-7893 |
Tara Noelle Tappe, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 9220 Bass Lake Rd Ste 255, New Hope, MN 55428 Phone: 763-225-4052 | |
Katie Suzanne Perzel, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 9220 Bass Lake Rd Ste 255, New Hope, MN 55428 Phone: 763-225-4052 | |
Jaleesa Lenoir, MSW, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 5555 Boone Ave N, New Hope, MN 55428 Phone: 651-774-0011 Fax: 651-774-0606 | |
Farah Ahamed Noorani, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 5555 Boone Ave N, New Hope, MN 55428 Phone: 651-774-0011 Fax: 651-774-0606 | |
Hannah Claire Langholz, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 5555 Boone Ave N, New Hope, MN 55428 Phone: 651-774-0011 Fax: 651-774-0606 | |
Bree Lynn Meduna, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 5555 Boone Ave N, New Hope, MN 55428 Phone: 651-774-0011 Fax: 651-774-0606 |