| Ingersoll Associates Llc | |
|
5522 W Bald Eagle Blvd White Bear Lake MN 55110-6412 | |
| (651) 429-0838 | |
| Not Available |
| Full Name | Ingersoll Associates Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 5522 W Bald Eagle Blvd, White Bear Lake, Minnesota |
| Authorized Official Name and Position | Mina Ingersol (OWNER) |
| Authorized Official Contact | 6514290838 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ingersoll Associates Llc 5522 W Bald Eagle Blvd White Bear Lake MN 55110-6412 Ph: (651) 429-0838 | Ingersoll Associates Llc 5522 W Bald Eagle Blvd White Bear Lake MN 55110-6412 Ph: (651) 429-0838 |
| NPI Number | 1841353232 |
|---|---|
| Provider Enumeration Date | 12/18/2006 |
| Last Update Date | 11/24/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841353232 | NPI | - | NPPES |
| 220058900 | Medicaid | MN | |
| 56088DR | Other | MN | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 01313 (Minnesota) | Primary |
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