Charell Dutton, | |
13100 Wayzata Blvd Ste 200, Minnetonka, MN 55305-1810 | |
(952) 206-2040 | |
Not Available |
Full Name | Charell Dutton |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 13100 Wayzata Blvd Ste 200, Minnetonka, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1063079762 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 2117 (Minnesota) | Primary |
Entity Name | Nystrom & Associates Ltd |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1396750188 PECOS PAC ID: 6406752492 Enrollment ID: O20031210000592 |
Entity Name | Carver County |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1326049685 PECOS PAC ID: 8527041961 Enrollment ID: O20040609000094 |
Mailing Address | Practice Location Address |
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Charell Dutton, 540 E 1st St, Waconia, MN 55387-1600 Ph: (952) 442-4437 | Charell Dutton, 13100 Wayzata Blvd Ste 200, Minnetonka, MN 55305-1810 Ph: (952) 206-2040 |
James Patrick Mcenroe, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 11900 Wayzata Blvd Ste 100, Minnetonka, MN 55305 Phone: 612-454-2412 Fax: 952-546-1683 | |
Michelle Carey, Counselor Medicare: Not Enrolled in Medicare Practice Location: 10101 Bren Rd E Unit 414, Minnetonka, MN 55343 Phone: 763-242-1659 | |
Jamie L.k. Rohwer, L.P.C.C. Counselor Medicare: Medicare Enrolled Practice Location: 5125 County Road 101, Suite 300, Minnetonka, MN 55345 Phone: 952-932-7277 Fax: 952-932-9827 | |
Jordan Nielsen, Counselor Medicare: Not Enrolled in Medicare Practice Location: 360 Carlson Pkwy Apt 105, Minnetonka, MN 55305 Phone: 763-744-7359 | |
Meghan Elizabeth Hof, MA, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3395 Plymouth Rd, Minnetonka, MN 55305 Phone: 952-939-0396 | |
Jennifer Petzoldt, Counselor Medicare: Not Enrolled in Medicare Practice Location: 5860 Baker Rd, Minnetonka, MN 55345 Phone: 612-759-2697 |