| Edges Wellness Center Llc | |
|
730 E 38th St Suite 101 Minneapolis MN 55407-2572 | |
| (612) 272-3016 | |
| (888) 778-2961 |
| Full Name | Edges Wellness Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 730 E 38th St, Minneapolis, Minnesota |
| Authorized Official Name and Position | Mark J Reese (PARTNER THERAPIST) |
| Authorized Official Contact | 6122723016 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edges Wellness Center Llc 730 E 38th St Ste 101 Minneapolis MN 55407-5218 Ph: (612) 272-3016 | Edges Wellness Center Llc 730 E 38th St Suite 101 Minneapolis MN 55407-2572 Ph: (612) 272-3016 |
| NPI Number | 1306389861 |
|---|---|
| Provider Enumeration Date | 11/30/2016 |
| Last Update Date | 09/25/2024 |
| Certification Date | 09/25/2024 |
| Medicare PECOS PAC ID | 9638613607 |
|---|---|
| Medicare Enrollment ID | O20240701003427 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306389861 | NPI | - | NPPES |
| Provider Name | Margaret W Druschel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013313287 PECOS PAC ID: 9739591660 Enrollment ID: I20201216003105 |
| Provider Name | Mark Reese |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1700297454 PECOS PAC ID: 0446794416 Enrollment ID: I20240718000788 |
| Provider Name | Alex Iantaffi |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1275870875 PECOS PAC ID: 9537603501 Enrollment ID: I20240805000210 |
| Provider Name | Leisha L Suggs |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1881354728 PECOS PAC ID: 7315485992 Enrollment ID: I20240814000837 |
| Provider Name | Casey Orvis Skeide |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1215796149 PECOS PAC ID: 1052859519 Enrollment ID: I20240814004431 |
| Provider Name | Bex Mae Wilde |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1609630458 PECOS PAC ID: 1951849371 Enrollment ID: I20240816001554 |
| Provider Name | Kaj E Benson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1962927129 PECOS PAC ID: 5890233134 Enrollment ID: I20240816002966 |
| Provider Name | Kimberia Joy Sherva |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1447963798 PECOS PAC ID: 8224577135 Enrollment ID: I20240823000091 |
| Provider Name | Lora Strey Shokes |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1083363162 PECOS PAC ID: 8325589955 Enrollment ID: I20240923001152 |
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