Emily Ann Groteboer-distad, MS, LPCC, NCC | |
15265 Carrousel Way Ste 100, Rosemount, MN 55068-1760 | |
(952) 443-4600 | |
Not Available |
Full Name | Emily Ann Groteboer-distad |
---|---|
Gender | Female |
Speciality | Counselor - Mental Health |
Location | 15265 Carrousel Way Ste 100, Rosemount, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1942855408 | NPI | - | NPPES |
NA | Other | NA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
101YM0800X | Counselor - Mental Health | CC02555 (Minnesota) | Primary |
Entity Name | Ellie Family Services Pllp |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1740664150 PECOS PAC ID: 8325309669 Enrollment ID: O20180228001972 |
Mailing Address | Practice Location Address |
---|---|
Emily Ann Groteboer-distad, MS, LPCC, NCC Po Box 51, Victoria, MN 55386-0051 Ph: (952) 443-4600 | Emily Ann Groteboer-distad, MS, LPCC, NCC 15265 Carrousel Way Ste 100, Rosemount, MN 55068-1760 Ph: (952) 443-4600 |
Kimberly Swanson, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 14325 Cormorant Way, Rosemount, MN 55068 Phone: 612-532-8455 | |
Mr. Brian Paul Ario, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 12802 S Robert Trl, Rosemount, MN 55068 Phone: 952-388-4110 | |
Jennifer Ario, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 12802 S Robert Trl, Rosemount, MN 55068 Phone: 952-388-4850 | |
Kelly J Kivel, LPCC, LPC Counselor Medicare: Medicare Enrolled Practice Location: 15265 Carrousel Way, Rosemount, MN 55068 Phone: 952-443-4600 | |
Mrs. Christina Anne Preston, MA, LADC Counselor Medicare: Medicare Enrolled Practice Location: 15265 Carrousel Way, Rosemount, MN 55068 Phone: 952-443-4600 Fax: 952-443-4604 | |
Alyssa Rose Kittleson, MSW Counselor Medicare: Medicare Enrolled Practice Location: 15265 Carrousel Way, Rosemount, MN 55068 Phone: 952-443-4600 | |
Madeline Bullock, Counselor Medicare: Medicare Enrolled Practice Location: 2802 145th St W, Rosemount, MN 55068 Phone: 651-387-0616 |