| Introspect Mental Health Llc | |
|
4801 Highway 61 N Ste 204 White Bear Lk MN 55110-2752 | |
| (763) 465-6700 | |
| Not Available |
| Full Name | Introspect Mental Health Llc |
|---|---|
| Speciality | Counselor |
| Location | 4801 Highway 61 N Ste 204, White Bear Lk, Minnesota |
| Authorized Official Name and Position | Samantha Yerks (OWNER) |
| Authorized Official Contact | 6512718970 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Introspect Mental Health Llc 22130 Typo Creek Dr Ne Wyoming MN 55092-4602 Ph: (651) 271-8970 | Introspect Mental Health Llc 4801 Highway 61 N Ste 204 White Bear Lk MN 55110-2752 Ph: (763) 465-6700 |
| NPI Number | 1184273666 |
|---|---|
| Provider Enumeration Date | 09/08/2019 |
| Last Update Date | 05/15/2024 |
| Certification Date | 05/15/2024 |
| Medicare PECOS PAC ID | 9931502796 |
|---|---|
| Medicare Enrollment ID | O20210730002128 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184273666 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Rebecca Gruber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740578475 PECOS PAC ID: 4183892730 Enrollment ID: I20190509001474 |
| Provider Name | Samantha Louise Yerks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336374750 PECOS PAC ID: 3375875446 Enrollment ID: I20210730002191 |
| Provider Name | Susan R Peterson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679113823 PECOS PAC ID: 2365814910 Enrollment ID: I20230208003048 |
| Provider Name | Carissa Joyce White |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922632363 PECOS PAC ID: 0446603484 Enrollment ID: I20240126000396 |
| Provider Name | Candace Rae Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912638552 PECOS PAC ID: 9537605670 Enrollment ID: I20240724003598 |
| Provider Name | Dana Daly Kromar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477392991 PECOS PAC ID: 5799224994 Enrollment ID: I20240903000670 |
| Provider Name | Zachariah Sears |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306545330 PECOS PAC ID: 9335680339 Enrollment ID: I20240918000588 |
| Provider Name | Brittany Kay Crock |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1942063458 PECOS PAC ID: 7618401928 Enrollment ID: I20241108002989 |
Venture Therapy, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2504 8th St, White Bear Lk, MN 55110 Phone: 651-472-2903 |