| Interpersonal Mental Health Llc | |
|
6 E Diamond Lake Rd Minneapolis MN 55419-1923 | |
| (612) 590-8070 | |
| Not Available |
| Full Name | Interpersonal Mental Health Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 6 E Diamond Lake Rd, Minneapolis, Minnesota |
| Authorized Official Name and Position | Stanley F Theiele (OWNER) |
| Authorized Official Contact | 6125908070 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Interpersonal Mental Health Llc 6 E Diamond Lake Rd Minneapolis MN 55419-1923 Ph: (612) 590-8070 | Interpersonal Mental Health Llc 6 E Diamond Lake Rd Minneapolis MN 55419-1923 Ph: (612) 590-8070 |
| NPI Number | 1376392613 |
|---|---|
| Provider Enumeration Date | 05/17/2024 |
| Last Update Date | 05/17/2024 |
| Certification Date | 05/17/2024 |
| Medicare PECOS PAC ID | 8224572839 |
|---|---|
| Medicare Enrollment ID | O20240705002916 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376392613 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Stanley Farrell Thiele |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1992442180 PECOS PAC ID: 9133663743 Enrollment ID: I20240706000243 |
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