| Heartspring, Llc | |
|
5047 30th Ave S Minneapolis MN 55417-1309 | |
| (612) 747-1325 | |
| Not Available |
| Full Name | Heartspring, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 5047 30th Ave S, Minneapolis, Minnesota |
| Authorized Official Name and Position | Laura J Johnson (PSYCHOTHERAPIST) |
| Authorized Official Contact | 6127471325 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heartspring, Llc 5047 30th Ave S Minneapolis MN 55417-1309 Ph: (651) 276-5538 | Heartspring, Llc 5047 30th Ave S Minneapolis MN 55417-1309 Ph: (612) 747-1325 |
| NPI Number | 1558731422 |
|---|---|
| Provider Enumeration Date | 10/04/2015 |
| Last Update Date | 03/29/2023 |
| Certification Date | 03/29/2023 |
| Medicare PECOS PAC ID | 5890095954 |
|---|---|
| Medicare Enrollment ID | O20151123001225 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558731422 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 19191 (Minnesota) | Primary |
| Provider Name | Laura J Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194056812 PECOS PAC ID: 7810149978 Enrollment ID: I20121218000521 |
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