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1405 Lilac Dr N Ste 113f Golden Valley MN 55422-4528 | |
| (920) 737-7961 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1405 Lilac Dr N Ste 113f, Golden Valley, Minnesota |
| Authorized Official Name and Position | Katie Marie Marsh (OWNER) |
| Authorized Official Contact | 9207377961 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6739 Golden Valley Rd Golden Valley MN 55427-4618 Ph: (920) 737-7961 | 1405 Lilac Dr N Ste 113f Golden Valley MN 55422-4528 Ph: (920) 737-7961 |
| NPI Number | 1376154633 |
|---|---|
| Provider Enumeration Date | 08/11/2020 |
| Last Update Date | 12/16/2020 |
| Certification Date | 12/16/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376154633 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
Lucinda Cummings, Ph.d., Lp, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8085 Wayzata Blvd, #212, Golden Valley, MN 55426 Phone: 763-546-1796 Fax: 763-546-8260 | |
Stephanie Untiedt, Phd, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5101 Olson Memorial Hwy Ste 4007, Golden Valley, MN 55422 Phone: 763-595-7294 Fax: 763-595-7293 | |
Buice Behavioral Healthcare Consultants Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1710 Douglas Dr N Ste 120, Golden Valley, MN 55422 Phone: 763-807-5254 Fax: 763-465-3032 |