| Choices Psychotherapy, Ltd. | |
|
10201 Wayzata Blvd Ste 100 Minnetonka MN 55305-1500 | |
| (952) 544-6806 | |
| (952) 545-0098 |
| Full Name | Choices Psychotherapy, Ltd. |
|---|---|
| Speciality | Counselor |
| Location | 10201 Wayzata Blvd Ste 100, Minnetonka, Minnesota |
| Authorized Official Name and Position | Susan Marie Davis (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9525446806 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Choices Psychotherapy, Ltd. 715 Florida Ave S Suite 307 St Louis Park MN 55426-1719 Ph: (952) 544-6806 | Choices Psychotherapy, Ltd. 10201 Wayzata Blvd Ste 100 Minnetonka MN 55305-1500 Ph: (952) 544-6806 |
| NPI Number | 1134171127 |
|---|---|
| Provider Enumeration Date | 05/17/2006 |
| Last Update Date | 08/13/2021 |
| Certification Date | 08/13/2021 |
| Medicare PECOS PAC ID | 8426064338 |
|---|---|
| Medicare Enrollment ID | O20060302000127 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134171127 | NPI | - | NPPES |
| 312P4CH | Other | MN | BCBS LP GROUP ID |
| 620S7CH | Other | MN | BCBS LMFT |
| 060825400 | Medicaid | MN | |
| 804356000 | Other | MN | MAGELLEN GROUP ID |
| 5G669DA | Other | MN | BCBS LICSW GROUP ID |
| 7500691 | Other | MN | AETNA GROUP |
| 630079100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Cynthia M Belt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306950050 PECOS PAC ID: 8022094879 Enrollment ID: I20040624000868 |
| Provider Name | Susan M Winslow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467539726 PECOS PAC ID: 4183696594 Enrollment ID: I20040806000894 |
| Provider Name | Juliette E Petersen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790891950 PECOS PAC ID: 4688617616 Enrollment ID: I20050609000887 |
| Provider Name | Carrie D Parente |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992791651 PECOS PAC ID: 4688692205 Enrollment ID: I20051102000836 |
| Provider Name | Ranji Varghese |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255304770 PECOS PAC ID: 5890714083 Enrollment ID: I20051116000987 |
| Provider Name | Jennifer L Vlach |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184692949 PECOS PAC ID: 2062414527 Enrollment ID: I20070213000187 |
| Provider Name | Anna Igorevna Yurchenko |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326189879 PECOS PAC ID: 7416048848 Enrollment ID: I20070814000355 |
| Provider Name | Milos Zivkovic |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881712693 PECOS PAC ID: 1658446034 Enrollment ID: I20080819000894 |
| Provider Name | Ann R Trench |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699913327 PECOS PAC ID: 2163569658 Enrollment ID: I20091103000175 |
| Provider Name | Erin C Soto |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881855484 PECOS PAC ID: 9436305489 Enrollment ID: I20120808000162 |
| Provider Name | Adnan Ahmed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063737153 PECOS PAC ID: 4385881341 Enrollment ID: I20130510000253 |
| Provider Name | Anne M Mcdonald |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801275672 PECOS PAC ID: 0244541639 Enrollment ID: I20150626000284 |
| Provider Name | Mary C Murzyn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326424722 PECOS PAC ID: 5193033132 Enrollment ID: I20150924002334 |
| Provider Name | Amber L Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205129285 PECOS PAC ID: 3577703990 Enrollment ID: I20160606002292 |
| Provider Name | Jill A Kramer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275655474 PECOS PAC ID: 9032353859 Enrollment ID: I20161019001560 |
| Provider Name | John L Vukelich |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568789717 PECOS PAC ID: 2668693722 Enrollment ID: I20161110000069 |
| Provider Name | Carrie Snyder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699001784 PECOS PAC ID: 2961773312 Enrollment ID: I20170803002905 |
| Provider Name | Alfredo A Massa Succar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639362361 PECOS PAC ID: 8123398955 Enrollment ID: I20181010003097 |
| Provider Name | Robert J Mccauley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659929867 PECOS PAC ID: 0446581359 Enrollment ID: I20191008000484 |
| Provider Name | Laurie A. Camilli |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689276917 PECOS PAC ID: 9032522974 Enrollment ID: I20210113002101 |
| Provider Name | Cyrus Hair |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386300721 PECOS PAC ID: 3870982663 Enrollment ID: I20211117000815 |
| Provider Name | Michelle L Tschida |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1679924294 PECOS PAC ID: 2860835220 Enrollment ID: I20240213002164 |
| Provider Name | Leah M Austin |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1568703064 PECOS PAC ID: 1951745199 Enrollment ID: I20240215003483 |
| Provider Name | Lance M Terwedo |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1356689517 PECOS PAC ID: 0244674372 Enrollment ID: I20240216002715 |
| Provider Name | Jael L Mohnkern Miles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891204103 PECOS PAC ID: 4284078015 Enrollment ID: I20240220001728 |
| Provider Name | Dawn K Schuldt |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1699836221 PECOS PAC ID: 6406290816 Enrollment ID: I20240228000070 |
| Provider Name | Rachel Footh Moran |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1609176627 PECOS PAC ID: 5698112076 Enrollment ID: I20240320003778 |
| Provider Name | Roxanne M Prince |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932665098 PECOS PAC ID: 6305282047 Enrollment ID: I20240405003667 |
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