| Iris Mental Health & Wellness | |
|
101 W Burnsville Pkwy Ste 207 Burnsville MN 55337-0010 | |
| (612) 548-4266 | |
| (952) 686-6966 |
| Full Name | Iris Mental Health & Wellness |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 101 W Burnsville Pkwy Ste 207, Burnsville, Minnesota |
| Authorized Official Name and Position | Crystal Clancy (LIC. MARRIAGE & FAMILY THERAPIST) |
| Authorized Official Contact | 6125484266 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Iris Mental Health & Wellness 101 W Burnsville Pkwy Ste 207 Burnsville MN 55337-0010 Ph: (612) 548-4266 | Iris Mental Health & Wellness 101 W Burnsville Pkwy Ste 207 Burnsville MN 55337-0010 Ph: (612) 548-4266 |
| NPI Number | 1023528213 |
|---|---|
| Provider Enumeration Date | 10/03/2017 |
| Last Update Date | 12/13/2023 |
| Certification Date | 12/13/2023 |
| Medicare PECOS PAC ID | 2365895844 |
|---|---|
| Medicare Enrollment ID | O20240131003953 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023528213 | NPI | - | NPPES |
| 3836220 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Lindsey A Mehran Rezaii |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497181507 PECOS PAC ID: 4082840384 Enrollment ID: I20131114001550 |
| Provider Name | Shaylin A Theisen |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1205216983 PECOS PAC ID: 5698015121 Enrollment ID: I20190320002013 |
| Provider Name | Megan M Miller |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1124653225 PECOS PAC ID: 8921437062 Enrollment ID: I20200410001302 |
| Provider Name | Crystal Leah Clancy |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1578703559 PECOS PAC ID: 1355794835 Enrollment ID: I20240131004162 |
| Provider Name | Shannon Marie Wohlman |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1932616893 PECOS PAC ID: 5496126849 Enrollment ID: I20240208003087 |
| Provider Name | Ashley Rae Roberts Mitchell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679020697 PECOS PAC ID: 5597109538 Enrollment ID: I20240219001462 |
| Provider Name | Chelsea Marie Brumme |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144595612 PECOS PAC ID: 2264876978 Enrollment ID: I20240221003530 |
| Provider Name | Sarah Ann Doll |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538367966 PECOS PAC ID: 9931545985 Enrollment ID: I20240312003865 |
| Provider Name | Frank Joseph Brumme |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083914121 PECOS PAC ID: 5890132963 Enrollment ID: I20240325002779 |
| Provider Name | Britnie Lou Krueger |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1003386087 PECOS PAC ID: 5991144495 Enrollment ID: I20240417000697 |
| Provider Name | Elyse Suzanne Robinson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376233445 PECOS PAC ID: 2264873454 Enrollment ID: I20240520001192 |
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