Nicholas Weidner, | |
7580 160th St W, Lakeville, MN 55044-8348 | |
(952) 898-1133 | |
Not Available |
Full Name | Nicholas Weidner |
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Gender | Male |
Speciality | Counselor - Mental Health |
Location | 7580 160th St W, Lakeville, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1033627716 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | 304455 (Minnesota) | Secondary |
101YM0800X | Counselor - Mental Health | CC1831 (Minnesota) | Primary |
Entity Name | Life Development Resources Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1902953169 PECOS PAC ID: 5890779847 Enrollment ID: O20040616000985 |
Mailing Address | Practice Location Address |
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Nicholas Weidner, 13288 Brass Pkwy, Rosemount, MN 55068-2772 Ph: () - | Nicholas Weidner, 7580 160th St W, Lakeville, MN 55044-8348 Ph: (952) 898-1133 |
Heather Leann Wegner, MA, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 16233 Kenyon Ave, Lakeville, MN 55044 Phone: 800-438-1772 Fax: 262-293-9737 | |
Anna Marie Groen, Counselor Medicare: Not Enrolled in Medicare Practice Location: 7580 160th St. W.,, Lakeville, MN 55044 Phone: 952-564-6281 Fax: 952-435-6797 | |
Jennifer Tessness, Counselor Medicare: Not Enrolled in Medicare Practice Location: 7580 160th St W, Lakeville, MN 55044 Phone: 952-898-1133 | |
Ms. Julia Swedberg, MA, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 10591 165th St W, Lakeville, MN 55044 Phone: 952-898-1133 Fax: 952-435-6797 | |
Tracy Kotval, MA, L.P.C.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 10535 165th St W, Lakeville, MN 55044 Phone: 612-787-2297 | |
Mrs. Michelle Marie Rude, MA, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 10535 165th St W, Lakeville, MN 55044 Phone: 952-435-0022 |