| Headwaters Mental Health, Ltd. | |
|
1614 Harmon Pl Ste 301 Minneapolis MN 55403-1965 | |
| (612) 470-7055 | |
| Not Available |
| Full Name | Headwaters Mental Health, Ltd. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1614 Harmon Pl Ste 301, Minneapolis, Minnesota |
| Authorized Official Name and Position | Jillian Chmiel (OWNER) |
| Authorized Official Contact | 6127598934 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Headwaters Mental Health, Ltd. Po Box 8147 Saint Paul MN 55108-0147 Ph: (612) 759-8934 | Headwaters Mental Health, Ltd. 1614 Harmon Pl Ste 301 Minneapolis MN 55403-1965 Ph: (612) 470-7055 |
| NPI Number | 1699526210 |
|---|---|
| Provider Enumeration Date | 04/01/2024 |
| Last Update Date | 04/01/2024 |
| Certification Date | 03/31/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699526210 | NPI | - | NPPES |
| 1770140311 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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