| Lauren Andrea Maccoux Kizaur, LICSW | |
|
1385 Mendota Heights Rd Ste 200, Mendota Heights, MN 55120-1289 | |
| (651) 379-9800 | |
| Not Available |
| Full Name | Lauren Andrea Maccoux Kizaur |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 1385 Mendota Heights Rd Ste 200, Mendota Heights, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548721079 | NPI | - | NPPES |
| 25455 | Other | MN | BOARD OF SOCIAL WORK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 25455 (Minnesota) | Primary |
| Entity Name | Wild Tree Psychotherapy Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528451408 PECOS PAC ID: 8426408881 Enrollment ID: O20231227001431 |
| Mailing Address | Practice Location Address |
|---|---|
| Lauren Andrea Maccoux Kizaur, LICSW 1385 Mendota Heights Rd Ste 200, Mendota Heights, MN 55120-1289 Ph: (651) 379-9800 | Lauren Andrea Maccoux Kizaur, LICSW 1385 Mendota Heights Rd Ste 200, Mendota Heights, MN 55120-1289 Ph: (651) 379-9800 |
Kaitlin Salscheider, MSW, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1385 Mendota Heights Rd Ste 200, Mendota Heights, MN 55120 Phone: 651-379-9800 | |
Justin W Swanson, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 750 S Plaza Dr Ste 100, Mendota Heights, MN 55120 Phone: 612-227-9014 Fax: 651-455-1385 | |
Miranda D Barker, MSW LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1370 Mendota Heights Rd, Mendota Heights, MN 55120 Phone: 319-504-5657 | |
Evy Christine Hultgren, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1370 Mendota Heights Rd, Mendota Heights, MN 55120 Phone: 651-313-8080 | |
Daniel Grant Christensen-cowan, MSW, LGSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 675 Cheyenne Ln, Mendota Heights, MN 55120 Phone: 651-216-1202 | |
Elizabeth M Anez, LCSW, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1385 Mendota Heights Rd Ste 200, Mendota Heights, MN 55120 Phone: 651-379-9800 Fax: 651-405-0358 | |
Sarah Kudishevich, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1155 Centre Pointe Dr Ste 8, Mendota Heights, MN 55120 Phone: 651-461-8033 |