Kelliann Kutschke, | |
1600 Madison Ave Ste 110, Mankato, MN 56001-5820 | |
(612) 220-0668 | |
Not Available |
Full Name | Kelliann Kutschke |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 1600 Madison Ave Ste 110, Mankato, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1720863798 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Entity Name | Ellie Family Services Pllp |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1740664150 PECOS PAC ID: 8325309669 Enrollment ID: O20180228001972 |
Mailing Address | Practice Location Address |
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Kelliann Kutschke, 1600 Madison Ave Ste 110, Mankato, MN 56001-5820 Ph: () - | Kelliann Kutschke, 1600 Madison Ave Ste 110, Mankato, MN 56001-5820 Ph: (612) 220-0668 |
K. Robin Newcombe Nelson, LADC, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1025 Marsh St, Mankato, MN 56001 Phone: 507-625-3372 | |
Lacy Osborne, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 100 Warren St # 345, Mankato, MN 56001 Phone: 507-227-4858 Fax: 507-519-2271 | |
Michele J. Larson, MSW, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 104 Serra St, Mankato, MN 56001 Phone: 608-577-5742 | |
Tammy M Gagnon, MSW, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 11 Civic Center Plz Ste 1615, Mankato, MN 56001 Phone: 507-345-4679 Fax: 507-345-8685 | |
Anna Marie Johanson, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1400 Madison Ave Ste 352, Mankato, MN 56001 Phone: 507-387-3195 | |
Nicole Kristina Lidstrom, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1025 Marsh St, Mankato, MN 56001 Phone: 507-594-2468 | |
Carrie Ann Leggett, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1025 Marsh St, Mankato, MN 56001 Phone: 507-400-4706 |