Lacey Severson, | |
2120 Clinton Ave, Minneapolis, MN 55404-2649 | |
(952) 405-7190 | |
Not Available |
Full Name | Lacey Severson |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 2120 Clinton Ave, Minneapolis, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1265064935 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 26356 (Minnesota) | Primary |
Entity Name | Park Nicollet Clinic |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1780621904 PECOS PAC ID: 7911819438 Enrollment ID: O20031104000046 |
Mailing Address | Practice Location Address |
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Lacey Severson, 6140 Quinwood Ln N Apt 4114, Plymouth, MN 55442-1294 Ph: () - | Lacey Severson, 2120 Clinton Ave, Minneapolis, MN 55404-2649 Ph: (952) 405-7190 |
Mr. Tim D Sullivan, MSW, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 229 Ridgewood Ave, Apartment 112, Minneapolis, MN 55403 Phone: 612-600-7169 | |
Catherine Elaine Schacher, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2525 Chicago Ave, Minneapolis, MN 55404 Phone: 612-813-6138 | |
Don Coleman, Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 2430 Nicollet Ave, Minneapolis, MN 55404 Phone: 612-871-1454 Fax: 612-871-1505 | |
Seare Shibeshi, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2327 E Franklin Ave Ste 3, Minneapolis, MN 55406 Phone: 612-332-9124 | |
Alex Jacob Hoyt, MSW, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 4027 County Road 25, Minneapolis, MN 55416 Phone: 612-925-6033 Fax: 612-925-8496 | |
Elissa J Allen, LGSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 2925 Chicago Ave, Minneapolis, MN 55407 Phone: 866-603-0016 | |
Sydney Bartz, MSW, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1100 Glenwood Ave, Minneapolis, MN 55405 Phone: 612-871-1454 |