| Chaska Counseling And Guidance, Llc | |
|
562 Bavaria Ln Chaska MN 55318-4597 | |
| (952) 484-3509 | |
| (952) 361-0145 |
| Full Name | Chaska Counseling And Guidance, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 562 Bavaria Ln, Chaska, Minnesota |
| Authorized Official Name and Position | Lisa Ann Knudson (SOLE PROPRIETOR) |
| Authorized Official Contact | 9524843509 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chaska Counseling And Guidance, Llc 562 Bavaria Ln Chaska MN 55318-4597 Ph: (952) 484-3509 | Chaska Counseling And Guidance, Llc 562 Bavaria Ln Chaska MN 55318-4597 Ph: (952) 484-3509 |
| NPI Number | 1588818769 |
|---|---|
| Provider Enumeration Date | 11/13/2008 |
| Last Update Date | 11/13/2008 |
| Medicare PECOS PAC ID | 8628139318 |
|---|---|
| Medicare Enrollment ID | O20081213000191 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588818769 | NPI | - | NPPES |
| 4138228110 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 10527 (Minnesota) | Primary |
| Provider Name | Lisa A Knudson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639246952 PECOS PAC ID: 7719048404 Enrollment ID: I20081213000189 |
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