| Integrated Life Counseling Center, Pllc | |
|
8931 33rd Street N Lake Elmo MN 55042-8900 | |
| (651) 242-9608 | |
| (651) 756-8138 |
| Full Name | Integrated Life Counseling Center, Pllc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 8931 33rd Street N, Lake Elmo, Minnesota |
| Authorized Official Name and Position | Tracy Lee Kaye Swanson (DIRECTOR OF COMMUNICATIONS) |
| Authorized Official Contact | 6512429608 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Life Counseling Center, Pllc 8931 33rd Street N Lake Elmo MN 55042-8900 Ph: (651) 242-9608 | Integrated Life Counseling Center, Pllc 8931 33rd Street N Lake Elmo MN 55042-8900 Ph: (651) 242-9608 |
| NPI Number | 1649644634 |
|---|---|
| Provider Enumeration Date | 11/14/2015 |
| Last Update Date | 09/02/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649644634 | NPI | - | NPPES |
| 1629138417 | Medicaid | MN | |
| 1225262496 | Medicaid | MN | |
| 1114091709 | Medicaid | MN | |
| 1154562205 | Medicaid | MN |
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