| Synergy Etherapy | |
|
3539 Douglas Dr N Minneapolis MN 55422-2415 | |
| (612) 642-1355 | |
| (612) 756-7059 |
| Full Name | Synergy Etherapy |
|---|---|
| Speciality | Psychologist |
| Location | 3539 Douglas Dr N, Minneapolis, Minnesota |
| Authorized Official Name and Position | Lisa Eileen Lovelace (OWNER, CLINICAL PSYCHOLOGY) |
| Authorized Official Contact | 6126421355 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Synergy Etherapy 3539 Douglas Dr N Minneapolis MN 55422-2415 Ph: (612) 642-1355 | Synergy Etherapy 3539 Douglas Dr N Minneapolis MN 55422-2415 Ph: (612) 642-1355 |
| NPI Number | 1770120933 |
|---|---|
| Provider Enumeration Date | 12/06/2019 |
| Last Update Date | 11/03/2021 |
| Certification Date | 11/03/2021 |
| Medicare PECOS PAC ID | 1951790955 |
|---|---|
| Medicare Enrollment ID | O20211112001623 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770120933 | NPI | - | NPPES |
| Provider Name | Lisa L Lovelace |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104090646 PECOS PAC ID: 9931267911 Enrollment ID: I20110919000721 |
| Provider Name | Patricia R Evans |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841215092 PECOS PAC ID: 3375714496 Enrollment ID: I20110922000068 |
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