Inner Wisdom Psychotherapy, Llc | |
205 W 2nd St Suite 431 Duluth MN 55802-1928 | |
(218) 310-8712 | |
(218) 216-1226 |
Full Name | Inner Wisdom Psychotherapy, Llc |
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Speciality | Social Worker |
Location | 205 W 2nd St, Duluth, Minnesota |
Authorized Official Name and Position | Patricia Ann Olson (SOLE MEMBER / OWNER) |
Authorized Official Contact | 2183108712 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Inner Wisdom Psychotherapy, Llc 205 W 2nd St Suite 431 Duluth MN 55802-1928 Ph: (218) 310-8712 | Inner Wisdom Psychotherapy, Llc 205 W 2nd St Suite 431 Duluth MN 55802-1928 Ph: (218) 310-8712 |
NPI Number | 1497111686 |
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Provider Enumeration Date | 01/05/2016 |
Last Update Date | 01/05/2016 |
Medicare PECOS PAC ID | 9739485681 |
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Medicare Enrollment ID | O20160302002907 |
Identifier | Type | State | Issuer |
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1497111686 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | (Minnesota) | Primary |
Provider Name | Patricia A Olson |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1699875971 PECOS PAC ID: 1153496906 Enrollment ID: I20080829000086 |
Provider Name | Carin Maris Mizera |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1205904521 PECOS PAC ID: 2264442565 Enrollment ID: I20171009003460 |
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