| Fields Of Grace Counseling And Wellness Inc | |
|
310 1/2 Main St S Stillwater MN 55082 | |
| (651) 236-0976 | |
| Not Available |
| Full Name | Fields Of Grace Counseling And Wellness Inc |
|---|---|
| Speciality | Psychologist |
| Location | 310 1/2 Main St S, Stillwater, Minnesota |
| Authorized Official Name and Position | Carissa Stepan (CO-OWNER) |
| Authorized Official Contact | 6512360976 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fields Of Grace Counseling And Wellness Inc 310 1/2 Main St S Stillwater MN 55082 Ph: (651) 236-0976 | Fields Of Grace Counseling And Wellness Inc 310 1/2 Main St S Stillwater MN 55082 Ph: (651) 236-0976 |
| NPI Number | 1639747918 |
|---|---|
| Provider Enumeration Date | 06/14/2021 |
| Last Update Date | 06/14/2021 |
| Certification Date | 05/28/2021 |
| Medicare PECOS PAC ID | 8123425048 |
|---|---|
| Medicare Enrollment ID | O20210920003030 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639747918 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Carissa E Stepan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114257417 PECOS PAC ID: 4486780129 Enrollment ID: I20100331001292 |
| Provider Name | Rachel L Parkin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740601921 PECOS PAC ID: 4284862939 Enrollment ID: I20140102000971 |
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