Brenda Jean Demotte, MSW, LICSW | |
14985 Glazier Ave, Suite 555, Apple Valley, MN 55124-7484 | |
(952) 891-2525 | |
(952) 891-1800 |
Full Name | Brenda Jean Demotte |
---|---|
Gender | Female |
Speciality | Counselor - Mental Health |
Location | 14985 Glazier Ave, Apple Valley, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1144307471 | NPI | - | NPPES |
990991046670 | Other | MN | PREFERREDONE ADMINISTRATA |
02S54DE | Other | MN | BLUECROSS AND BLUESHIELD |
62-41666 | Other | MN | MEDICA |
V41193711663852 | Other | MN | HELATHPARTNERS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 05559 (Minnesota) | Primary |
Entity Name | Professional Counseling & Grief Services Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1508174681 PECOS PAC ID: 3577749555 Enrollment ID: O20110510000304 |
Mailing Address | Practice Location Address |
---|---|
Brenda Jean Demotte, MSW, LICSW 13027 Garvin Brook Ln, Apple Valley, MN 55124-7245 Ph: (952) 432-2669 | Brenda Jean Demotte, MSW, LICSW 14985 Glazier Ave, Suite 555, Apple Valley, MN 55124-7484 Ph: (952) 891-2525 |
Richard Dauer, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 6470 129th St W, Apple Valley, MN 55124 Phone: 651-402-9564 | |
Lindsey K Reichert, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 7300 147th St W, Suite 204, Apple Valley, MN 55124 Phone: 952-997-3020 Fax: 952-997-3026 | |
Noah Stoltzman, Counselor Medicare: Not Enrolled in Medicare Practice Location: 7300 147th St W Ste 600, Apple Valley, MN 55124 Phone: 952-997-3020 Fax: 952-997-3026 | |
Ms. Kristin Marie Baker, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 7300 147th St W Ste 600, Apple Valley, MN 55124 Phone: 952-997-3020 Fax: 952-997-3026 | |
Heather Hislop-anderson, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 7300 147th St W Ste 204, Apple Valley, MN 55124 Phone: 952-997-3020 | |
Brittany M Schug, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 7300 147th St W, Apple Valley, MN 55124 Phone: 952-997-3020 Fax: 952-997-3026 | |
Alex Stolis, Counselor Medicare: Not Enrolled in Medicare Practice Location: 7300 147th St W Ste 204, Apple Valley, MN 55124 Phone: 952-997-3020 Fax: 952-997-3026 |