| Angela Brust, Llc | |
|
5200 Willson Rd Ste 307 Edina MN 55424-1344 | |
| (612) 987-8070 | |
| Not Available |
| Full Name | Angela Brust, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 5200 Willson Rd Ste 307, Edina, Minnesota |
| Authorized Official Name and Position | Angela Michelle Brust (PSYCHOTHERAPIST) |
| Authorized Official Contact | 6129878070 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Angela Brust, Llc 5960 Newton Ave S Minneapolis MN 55419-2017 Ph: (612) 987-8070 | Angela Brust, Llc 5200 Willson Rd Ste 307 Edina MN 55424-1344 Ph: (612) 987-8070 |
| NPI Number | 1023627593 |
|---|---|
| Provider Enumeration Date | 07/30/2020 |
| Last Update Date | 07/30/2020 |
| Certification Date | 07/30/2020 |
| Medicare PECOS PAC ID | 7911318274 |
|---|---|
| Medicare Enrollment ID | O20201118001568 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023627593 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Angela M Brust |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093014870 PECOS PAC ID: 8820273030 Enrollment ID: I20110504000316 |
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