| Guiding Stone Therapy And Wellness Llc | |
|
10501 Wayzata Blvd Ste 204 Minnetonka MN 55305-1519 | |
| (651) 398-2087 | |
| Not Available |
| Full Name | Guiding Stone Therapy And Wellness Llc |
|---|---|
| Speciality | Social Worker |
| Location | 10501 Wayzata Blvd Ste 204, Minnetonka, Minnesota |
| Authorized Official Name and Position | Kathleen Sprole (OWNER) |
| Authorized Official Contact | 6129150595 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Guiding Stone Therapy And Wellness Llc 9641 Washburn Ave S Bloomington MN 55431-2460 Ph: (612) 915-0595 | Guiding Stone Therapy And Wellness Llc 10501 Wayzata Blvd Ste 204 Minnetonka MN 55305-1519 Ph: (651) 398-2087 |
| NPI Number | 1609423755 |
|---|---|
| Provider Enumeration Date | 08/23/2019 |
| Last Update Date | 05/12/2021 |
| Certification Date | 05/12/2021 |
| Medicare PECOS PAC ID | 3173853066 |
|---|---|
| Medicare Enrollment ID | O20190918003281 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609423755 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kathleen M Sprole |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770887689 PECOS PAC ID: 5991962383 Enrollment ID: I20120214000462 |
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