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111 Market St Suite 2 Winona MN 55987 | |
(507) 454-2270 | |
(507) 457-3027 |
Full Name | |
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Speciality | Social Worker |
Location | 111 Market St, Winona, Minnesota |
Authorized Official Name and Position | Shanna Florence Harris (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 5074542270 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 379 Winona MN 55987-0379 Ph: () - | 111 Market St Suite 2 Winona MN 55987 Ph: (507) 454-2270 |
NPI Number | 1003848557 |
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Provider Enumeration Date | 07/07/2006 |
Last Update Date | 03/31/2022 |
Certification Date | 03/31/2022 |
Medicare PECOS PAC ID | 4880692581 |
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Medicare Enrollment ID | O20061113000198 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003848557 | NPI | - | NPPES |
231930600 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
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103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Annette J Krutsch |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1073769584 PECOS PAC ID: 8426125469 Enrollment ID: I20080917000557 |
Provider Name | Kristine M Madsen |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1518212687 PECOS PAC ID: 2769708528 Enrollment ID: I20150313001252 |
River City Psychiatric Services, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 902 E 2nd St Ste 113, Winona, MN 55987 Phone: 507-208-7629 Fax: 507-607-8671 | |
Hiawatha Valley Mental Health Center Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 420 E Sarnia St Ste 2100, Winona, MN 55987 Phone: 507-454-4341 Fax: 507-453-6267 |