| Eastwest Counseling And Consulting Pllc | |
|
18510 Mn-371 Suite A Brainerd MN 56401 | |
| (218) 537-8680 | |
| Not Available |
| Full Name | Eastwest Counseling And Consulting Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 18510 Mn-371, Brainerd, Minnesota |
| Authorized Official Name and Position | Casey Wagner (THERAPIST) |
| Authorized Official Contact | 2185378680 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastwest Counseling And Consulting Pllc 18510 Mn-371 Suite A Brainerd MN 56401 Ph: (218) 537-8680 | Eastwest Counseling And Consulting Pllc 18510 Mn-371 Suite A Brainerd MN 56401 Ph: (218) 537-8680 |
| NPI Number | 1164291902 |
|---|---|
| Provider Enumeration Date | 12/21/2023 |
| Last Update Date | 01/19/2024 |
| Certification Date | 01/19/2024 |
| Medicare PECOS PAC ID | 8921448176 |
|---|---|
| Medicare Enrollment ID | O20240503003398 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164291902 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Casey Wagner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740777838 PECOS PAC ID: 2466717012 Enrollment ID: I20180531001082 |
| Provider Name | Lily S. L. Wagner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366172066 PECOS PAC ID: 3274915558 Enrollment ID: I20220803000883 |
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