| Cedar River Counseling & Educational Services, Inc. | |
|
1403 15th Ave Nw Austin MN 55912-1911 | |
| (507) 433-6482 | |
| (507) 433-0097 |
| Full Name | Cedar River Counseling & Educational Services, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 1403 15th Ave Nw, Austin, Minnesota |
| Authorized Official Name and Position | Stanley R Miller (DIRECTOR/PSYCHOLOGIST) |
| Authorized Official Contact | 5074336482 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cedar River Counseling & Educational Services, Inc. 1403 15th Ave Nw Austin MN 55912-1911 Ph: (507) 433-6482 | Cedar River Counseling & Educational Services, Inc. 1403 15th Ave Nw Austin MN 55912-1911 Ph: (507) 433-6482 |
| NPI Number | 1679554497 |
|---|---|
| Provider Enumeration Date | 11/09/2005 |
| Last Update Date | 06/16/2009 |
| Medicare PECOS PAC ID | 6406906270 |
|---|---|
| Medicare Enrollment ID | O20090617000085 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679554497 | NPI | - | NPPES |
| 1265413777 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | LP3235 (Minnesota) | Primary |
| Provider Name | Stanley R Miller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265413777 PECOS PAC ID: 5597815357 Enrollment ID: I20090617000075 |
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