| Autonomy Counseling, Pllc | |
|
510 Center Ave Ste 2 Moorhead MN 56560-1922 | |
| (218) 293-4221 | |
| (218) 231-8914 |
| Full Name | Autonomy Counseling, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 510 Center Ave Ste 2, Moorhead, Minnesota |
| Authorized Official Name and Position | Marsha Marie Werner (OWNER) |
| Authorized Official Contact | 3608508588 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Autonomy Counseling, Pllc 5521 58th St S Fargo ND 58104-5689 Ph: (360) 850-8588 | Autonomy Counseling, Pllc 510 Center Ave Ste 2 Moorhead MN 56560-1922 Ph: (218) 293-4221 |
| NPI Number | 1437781515 |
|---|---|
| Provider Enumeration Date | 02/06/2020 |
| Last Update Date | 02/06/2020 |
| Certification Date | 02/06/2020 |
| Medicare PECOS PAC ID | 6305283847 |
|---|---|
| Medicare Enrollment ID | O20240320001753 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437781515 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Marsha M Werner |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1003265752 PECOS PAC ID: 1759728298 Enrollment ID: I20240320002006 |
| Provider Name | Jadin T Stromme |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558049619 PECOS PAC ID: 5395182620 Enrollment ID: I20240322001373 |
| Provider Name | Marsha Wichman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073901666 PECOS PAC ID: 0648617878 Enrollment ID: I20240325000965 |
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