| Experiencing Moore, Pc | |
|
1414 South Oak Ave Suite 6 Owatonna MN 55060-3957 | |
| (507) 676-6834 | |
| (507) 413-8088 |
| Full Name | Experiencing Moore, Pc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 1414 South Oak Ave, Owatonna, Minnesota |
| Authorized Official Name and Position | Margaret P Moore (PRESIDENT) |
| Authorized Official Contact | 5076766834 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Experiencing Moore, Pc 1414 South Oak Ave Suite 6 Owatonna MN 55060-3957 Ph: (507) 676-6834 | Experiencing Moore, Pc 1414 South Oak Ave Suite 6 Owatonna MN 55060-3957 Ph: (507) 676-6834 |
| NPI Number | 1740666122 |
|---|---|
| Provider Enumeration Date | 08/07/2015 |
| Last Update Date | 09/10/2021 |
| Certification Date | 09/10/2021 |
| Medicare PECOS PAC ID | 2466842364 |
|---|---|
| Medicare Enrollment ID | O20211208002841 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740666122 | NPI | - | NPPES |
| 4628710 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 1675 (Minnesota) | Primary |
| Provider Name | Kasey J Bishman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619190220 PECOS PAC ID: 8123124658 Enrollment ID: I20070430000571 |
| Provider Name | Shannon Melody Karsten |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295306298 PECOS PAC ID: 4789071390 Enrollment ID: I20220429001065 |
| Provider Name | Barbara Jo Schiltz |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1154733301 PECOS PAC ID: 2567812548 Enrollment ID: I20240103002788 |
| Provider Name | Margaret P Moore |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1184787632 PECOS PAC ID: 3072903970 Enrollment ID: I20240131001589 |
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