| Bergman Larson Consulting Llc | |
|
402 Washington St N Northfield MN 55057-5190 | |
| (507) 301-1982 | |
| Not Available |
| Full Name | Bergman Larson Consulting Llc |
|---|---|
| Speciality | Social Worker |
| Location | 402 Washington St N, Northfield, Minnesota |
| Authorized Official Name and Position | Krista M Larson (OWNER/CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 5073011982 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bergman Larson Consulting Llc 402 Washington St N Northfield MN 55057-5190 Ph: (507) 301-1982 | Bergman Larson Consulting Llc 402 Washington St N Northfield MN 55057-5190 Ph: (507) 301-1982 |
| NPI Number | 1831717107 |
|---|---|
| Provider Enumeration Date | 07/13/2020 |
| Last Update Date | 07/13/2020 |
| Certification Date | 07/13/2020 |
| Medicare PECOS PAC ID | 0042625873 |
|---|---|
| Medicare Enrollment ID | O20210209001000 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831717107 | NPI | - | NPPES |
| 787623800 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Krista M Larson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134250590 PECOS PAC ID: 8921199738 Enrollment ID: I20070808000721 |
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