| Counseling And Therapeutic Support Services Pllc | |
|
600 W 78th St Ste 10i Chanhassen MN 55317-2601 | |
| (612) 702-1976 | |
| Not Available |
| Full Name | Counseling And Therapeutic Support Services Pllc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 600 W 78th St Ste 10i, Chanhassen, Minnesota |
| Authorized Official Name and Position | Kathryn Marie-wilker Barrett (CEO/CFO) |
| Authorized Official Contact | 6127021976 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Counseling And Therapeutic Support Services Pllc Po Box 477 Chanhassen MN 55317-0477 Ph: () - | Counseling And Therapeutic Support Services Pllc 600 W 78th St Ste 10i Chanhassen MN 55317-2601 Ph: (612) 702-1976 |
| NPI Number | 1831545771 |
|---|---|
| Provider Enumeration Date | 05/10/2016 |
| Last Update Date | 12/08/2020 |
| Certification Date | 12/08/2020 |
| Medicare PECOS PAC ID | 1052723376 |
|---|---|
| Medicare Enrollment ID | O20201210001182 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831545771 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 2272 (Minnesota) | Primary |
| Provider Name | Kari L Vacinek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790127199 PECOS PAC ID: 0941529549 Enrollment ID: I20150504000560 |
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