| Grateful Heart Counseling Llc | |
|
115 Litchfield Ave Se Ste 202 Willmar MN 56201-3476 | |
| (320) 522-1411 | |
| Not Available |
| Full Name | Grateful Heart Counseling Llc |
|---|---|
| Speciality | Psychologist |
| Location | 115 Litchfield Ave Se Ste 202, Willmar, Minnesota |
| Authorized Official Name and Position | Angela Ann Lumbar (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 3205221411 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grateful Heart Counseling Llc Po Box 396 Fairfax MN 55332-0396 Ph: (320) 522-1411 | Grateful Heart Counseling Llc 115 Litchfield Ave Se Ste 202 Willmar MN 56201-3476 Ph: (320) 522-1411 |
| NPI Number | 1255906780 |
|---|---|
| Provider Enumeration Date | 05/26/2021 |
| Last Update Date | 10/14/2023 |
| Certification Date | 10/14/2023 |
| Medicare PECOS PAC ID | 8426459553 |
|---|---|
| Medicare Enrollment ID | O20210628001395 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255906780 | NPI | - | NPPES |
| 1700972320 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Angela Ann Lumbar |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700972320 PECOS PAC ID: 9537156930 Enrollment ID: I20210628001360 |
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