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116 Ash Ave Nw Suite 2 Wadena MN 56482-1347 | |
| (218) 640-7368 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 116 Ash Ave Nw, Wadena, Minnesota |
| Authorized Official Name and Position | Shari Lynn Phillips (OWNER/COUNSELOR) |
| Authorized Official Contact | 2186407368 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
310 3rd St Nw Wadena MN 56482-1118 Ph: (218) 640-7368 | 116 Ash Ave Nw Suite 2 Wadena MN 56482-1347 Ph: (218) 640-7368 |
| NPI Number | 1023691896 |
|---|---|
| Provider Enumeration Date | 04/29/2021 |
| Last Update Date | 07/17/2023 |
| Certification Date | 07/17/2023 |
| Medicare PECOS PAC ID | 9537509336 |
|---|---|
| Medicare Enrollment ID | O20240709002248 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023691896 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Katie L Tyrrell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609316355 PECOS PAC ID: 3971943770 Enrollment ID: I20240426001733 |
| Provider Name | Brittnee M Monson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679194716 PECOS PAC ID: 2466997986 Enrollment ID: I20240709002564 |
| Provider Name | Jordan Salwei |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760054027 PECOS PAC ID: 5698156982 Enrollment ID: I20240709003080 |
| Provider Name | Courtney A Van Den Bussche-doll |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699246983 PECOS PAC ID: 9537604087 Enrollment ID: I20240709003904 |
| Provider Name | Cheryl L Greenwaldt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679739635 PECOS PAC ID: 6406296201 Enrollment ID: I20240716002208 |
| Provider Name | Shari L Phillips |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710144266 PECOS PAC ID: 0143765651 Enrollment ID: I20240807003173 |
Neighborhood Counseling Center Of Wadena, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11 2nd St Sw, Wadena, MN 56482 Phone: 218-631-1714 |