| Abc Child & Family Therapy Center | |
|
40 16th St Se Suite D Rochester MN 55904-7987 | |
| (507) 536-7662 | |
| (507) 536-7664 |
| Full Name | Abc Child & Family Therapy Center |
|---|---|
| Speciality | Social Worker |
| Location | 40 16th St Se, Rochester, Minnesota |
| Authorized Official Name and Position | Judy M Dawley (DIRECTOR/THERAPIST) |
| Authorized Official Contact | 5075367662 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Abc Child & Family Therapy Center Po Box 894 Rochester MN 55903-0894 Ph: (507) 536-7662 | Abc Child & Family Therapy Center 40 16th St Se Suite D Rochester MN 55904-7987 Ph: (507) 536-7662 |
| NPI Number | 1255508537 |
|---|---|
| Provider Enumeration Date | 05/15/2008 |
| Last Update Date | 10/24/2008 |
| Medicare PECOS PAC ID | 7618035890 |
|---|---|
| Medicare Enrollment ID | O20081016000025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255508537 | NPI | - | NPPES |
| 144517100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 8385 (Minnesota) | Primary |
| Provider Name | Judy Marie Dawley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831289230 PECOS PAC ID: 7214036284 Enrollment ID: I20070618000025 |
| Provider Name | Dorothy B Wagner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033483649 PECOS PAC ID: 9234391608 Enrollment ID: I20120501000286 |
| Provider Name | Wayne J Luebbert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720308943 PECOS PAC ID: 3577818467 Enrollment ID: I20180618001403 |
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