| Grander Peace Counseling Llc | |
|
658 Grand Ave Ste 201 Saint Paul MN 55105-3492 | |
| (612) 454-1656 | |
| (651) 560-3768 |
| Full Name | Grander Peace Counseling Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 658 Grand Ave Ste 201, Saint Paul, Minnesota |
| Authorized Official Name and Position | Sheena C O'brien (OWNER/PSYCHOLOGIST) |
| Authorized Official Contact | 6124541656 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grander Peace Counseling Llc 658 Grand Ave Ste 201 Saint Paul MN 55105-3492 Ph: (612) 454-1656 | Grander Peace Counseling Llc 658 Grand Ave Ste 201 Saint Paul MN 55105-3492 Ph: (612) 454-1656 |
| NPI Number | 1013486505 |
|---|---|
| Provider Enumeration Date | 11/14/2018 |
| Last Update Date | 08/25/2024 |
| Certification Date | 08/25/2024 |
| Medicare PECOS PAC ID | 6204173362 |
|---|---|
| Medicare Enrollment ID | O20190128001439 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013486505 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Sheena C O'brien |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1598897373 PECOS PAC ID: 7012254170 Enrollment ID: I20190128001589 |
| Provider Name | Karen Mountainjohnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558829838 PECOS PAC ID: 5991156572 Enrollment ID: I20240108005114 |
| Provider Name | Kathleen Hughes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558553636 PECOS PAC ID: 5799138418 Enrollment ID: I20240130001273 |
| Provider Name | Jessica Marie Van Berkum |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1740682798 PECOS PAC ID: 0042758831 Enrollment ID: I20240812001502 |
| Provider Name | Maggie E. Omalley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841764339 PECOS PAC ID: 7719425511 Enrollment ID: I20240812001732 |
| Provider Name | Brooke Lee Boeckmann |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043838329 PECOS PAC ID: 9032650171 Enrollment ID: I20240917002401 |
| Provider Name | Sheena C O'brien |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598897373 PECOS PAC ID: 7012254170 Enrollment ID: I20241022001246 |
| Provider Name | Stacy Jean Christensen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346849015 PECOS PAC ID: 0840723441 Enrollment ID: I20241104000977 |
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