Mary Beth Thomas, LICSW | |
207 Avenue C, Suite 202, Cloquet, MN 55720-1584 | |
(218) 655-3347 | |
(218) 655-3390 |
Full Name | Mary Beth Thomas |
---|---|
Gender | Female |
Speciality | Social Worker - Clinical |
Location | 207 Avenue C, Cloquet, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1184746133 | NPI | - | NPPES |
800001494 | Other | MN | MEDICARE |
766160600 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 12849 (Minnesota) | Primary |
1041C0700X | Social Worker - Clinical | 993074 (Colorado) | Secondary |
Entity Name | Emily Program Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1528165065 PECOS PAC ID: 5193623254 Enrollment ID: O20031229000014 |
Mailing Address | Practice Location Address |
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Mary Beth Thomas, LICSW 207 Avenue C, Suite 202, Cloquet, MN 55720-1584 Ph: (218) 655-3347 | Mary Beth Thomas, LICSW 207 Avenue C, Suite 202, Cloquet, MN 55720-1584 Ph: (218) 655-3347 |
Kari Stroik, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 927 Trettel Ln, Cloquet, MN 55720 Phone: 218-879-1227 | |
Victoria Diane Zupancich, MSW, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 40 11th St, Cloquet, MN 55720 Phone: 218-879-4559 Fax: 218-879-0282 | |
Joni Christine Deetz, MSW, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 40 11th St, Cloquet, MN 55720 Phone: 218-879-4559 Fax: 218-879-0282 | |
Rochelle Marie Goodrich, LICSW Clinical Social Worker Medicare: May Accept Medicare Assignments Practice Location: Fond Du Lac Human Services Division, 927 Trettel Lane, Cloquet, MN 55720 Phone: 218-879-1227 Fax: 218-878-2188 | |
Samentha Kay Sakry, MSW, LGSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1618 Cloquet Ave, Cloquet, MN 55720 Phone: 218-451-2116 Fax: 218-219-1511 | |
Joie Ann Miletich, LICSW Clinical Social Worker Medicare: May Accept Medicare Assignments Practice Location: 118 Avenue C, Cloquet, MN 55720 Phone: 218-878-9352 Fax: 218-878-9342 | |
Thomas Udenberg, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1003 Cloquet Ave Ste 109, Cloquet, MN 55720 Phone: 218-606-1797 Fax: 651-925-0039 |