| Compass Rose Counseling And Wellness, Llc | |
|
118 Avenue C Cloquet MN 55720-1546 | |
| (218) 878-9352 | |
| Not Available |
| Full Name | Compass Rose Counseling And Wellness, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 118 Avenue C, Cloquet, Minnesota |
| Authorized Official Name and Position | Casey Lee Wyman (PSYCHOTHERAPIST/OWNER) |
| Authorized Official Contact | 2183419632 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Compass Rose Counseling And Wellness, Llc 118 Avenue C Cloquet MN 55720-1546 Ph: (218) 878-9352 | Compass Rose Counseling And Wellness, Llc 118 Avenue C Cloquet MN 55720-1546 Ph: (218) 878-9352 |
| NPI Number | 1962143974 |
|---|---|
| Provider Enumeration Date | 04/05/2022 |
| Last Update Date | 04/05/2022 |
| Certification Date | 04/04/2022 |
| Medicare PECOS PAC ID | 0244683167 |
|---|---|
| Medicare Enrollment ID | O20240126003755 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962143974 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Casey L Wyman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568892644 PECOS PAC ID: 1153774070 Enrollment ID: I20240126003811 |
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