| Aurora Psychological Services | |
|
4660 Slater Rd Suite 210 Eagan MN 55122-4047 | |
| (651) 882-6299 | |
| (651) 882-6299 |
| Full Name | Aurora Psychological Services |
|---|---|
| Speciality | Psychologist |
| Location | 4660 Slater Rd, Eagan, Minnesota |
| Authorized Official Name and Position | Annie Elizabeth Emanuel (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 6512741203 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aurora Psychological Services 4660 Slater Rd Suite 210 Eagan MN 55122-4047 Ph: (651) 882-6299 | Aurora Psychological Services 4660 Slater Rd Suite 210 Eagan MN 55122-4047 Ph: (651) 882-6299 |
| NPI Number | 1649378019 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 03/18/2024 |
| Certification Date | 03/18/2024 |
| Medicare PECOS PAC ID | 5294749883 |
|---|---|
| Medicare Enrollment ID | O20060202000919 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649378019 | NPI | - | NPPES |
| 83G50OL | Other | MN | BLUE CROSS BLUE SHIELD |
| 084673200 | Medicaid | MN | |
| 138155 | Other | MN | UCARE |
| HP58813 | Other | MN | HEALTH PARTNERS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | LP4645 (Minnesota) | Primary |
| Provider Name | Roger A Olsen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043347131 PECOS PAC ID: 0648284232 Enrollment ID: I20060202000939 |
| Provider Name | Annie Elizabeth Emanuel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205274990 PECOS PAC ID: 9931491453 Enrollment ID: I20160701000768 |
| Provider Name | Lindsey Ann Holm |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922552249 PECOS PAC ID: 8921352493 Enrollment ID: I20181120000476 |
| Provider Name | Julie Melton Sihilling |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992345037 PECOS PAC ID: 7911333851 Enrollment ID: I20200212001389 |
| Provider Name | Melissa Hirsch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851933881 PECOS PAC ID: 8224485834 Enrollment ID: I20231103000356 |
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