| Dbt And Emdr Specialists, P.a. | |
|
19377 Upland St Nw Elk River MN 55330-4140 | |
| (612) 237-7341 | |
| Not Available |
| Full Name | Dbt And Emdr Specialists, P.a. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 19377 Upland St Nw, Elk River, Minnesota |
| Authorized Official Name and Position | Leslie Fuchs (CEO) |
| Authorized Official Contact | 9046054986 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dbt And Emdr Specialists, P.a. 19377 Upland St Nw Elk River MN 55330-4140 Ph: (612) 237-7341 | Dbt And Emdr Specialists, P.a. 19377 Upland St Nw Elk River MN 55330-4140 Ph: (612) 237-7341 |
| NPI Number | 1750774162 |
|---|---|
| Provider Enumeration Date | 03/09/2015 |
| Last Update Date | 08/18/2023 |
| Medicare PECOS PAC ID | 2668755521 |
|---|---|
| Medicare Enrollment ID | O20170220001795 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750774162 | NPI | - | NPPES |
| 1245520048 | Other | MN | NPIJENNIFER KLUTCH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | CC291 LPCC (Minnesota) | Primary |
| Provider Name | Susan R Roeller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801193123 PECOS PAC ID: 8022293133 Enrollment ID: I20110504000408 |
| Provider Name | Katherine Elizabeth Schober-ordonez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932738101 PECOS PAC ID: 8224471180 Enrollment ID: I20240207002348 |
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