| Ksa Psychological Services, Llc | |
|
5603 Chicago Ave. Minneapolis MN 55417 | |
| (612) 298-9587 | |
| Not Available |
| Full Name | Ksa Psychological Services, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 5603 Chicago Ave., Minneapolis, Minnesota |
| Authorized Official Name and Position | Angela Scott (CO-OWNER/MANAGER) |
| Authorized Official Contact | 6122989587 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ksa Psychological Services, Llc 1034 Brompton Place Mendota Heights MN 55118 Ph: (612) 998-9587 | Ksa Psychological Services, Llc 5603 Chicago Ave. Minneapolis MN 55417 Ph: (612) 298-9587 |
| NPI Number | 1902306038 |
|---|---|
| Provider Enumeration Date | 02/15/2018 |
| Last Update Date | 02/15/2018 |
| Medicare PECOS PAC ID | 0648535054 |
|---|---|
| Medicare Enrollment ID | O20180605001707 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902306038 | NPI | - | NPPES |
| Provider Name | Kathryn M Christensen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790867315 PECOS PAC ID: 5991715005 Enrollment ID: I20060503000253 |
| Provider Name | Angela E Scott |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386696110 PECOS PAC ID: 5890706311 Enrollment ID: I20060518000079 |
| Provider Name | Shannon M Odonnell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053483453 PECOS PAC ID: 2668649633 Enrollment ID: I20120113000423 |
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