| Agassiz Associates, Pllc | |
|
2424 32nd Ave S Ste 202 Grand Forks ND 58201-6545 | |
| (701) 746-6336 | |
| (701) 772-1030 |
| Full Name | Agassiz Associates, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 2424 32nd Ave S, Grand Forks, North Dakota |
| Authorized Official Name and Position | Rebecca M. Green (CO-OWNER) |
| Authorized Official Contact | 7017466336 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Agassiz Associates, Pllc 2424 32nd Ave S Ste 202 Grand Forks ND 58201-6545 Ph: (701) 746-6336 | Agassiz Associates, Pllc 2424 32nd Ave S Ste 202 Grand Forks ND 58201-6545 Ph: (701) 746-6336 |
| NPI Number | 1700972122 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 01/23/2017 |
| Medicare PECOS PAC ID | 9335116417 |
|---|---|
| Medicare Enrollment ID | O20040916001019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700972122 | NPI | - | NPPES |
| 1457916 | Medicaid | ND | |
| 309K4AG | Other | MN | BLUECROSSBLUESHIELD OF MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Secondary |
| Provider Name | Rebecca M Green |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508951856 PECOS PAC ID: 4183690910 Enrollment ID: I20040902001349 |
| Provider Name | Heidi K Jensen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851487276 PECOS PAC ID: 8628044187 Enrollment ID: I20040907000327 |
| Provider Name | Melissa Quincer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801231048 PECOS PAC ID: 4082987698 Enrollment ID: I20170901002142 |
| Provider Name | Carissa Malevich |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851873046 PECOS PAC ID: 4880927359 Enrollment ID: I20190617000163 |
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