Laura Modl, | |
2450 Riverside Ave, Minneapolis, MN 55454-1450 | |
(612) 273-0001 | |
Not Available |
Full Name | Laura Modl |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 2450 Riverside 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 |
---|---|---|---|
1093402273 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Entity Name | Fairview Health Services |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1013994359 PECOS PAC ID: 1951213057 Enrollment ID: O20031105000461 |
Entity Name | Fairview Express Care |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053952606 PECOS PAC ID: 3375645179 Enrollment ID: O20081028000548 |
Mailing Address | Practice Location Address |
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Laura Modl, 2450 Riverside Ave, Minneapolis, MN 55454-1450 Ph: () - | Laura Modl, 2450 Riverside Ave, Minneapolis, MN 55454-1450 Ph: (612) 273-0001 |
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 |