| Lake Country Associates, Inc. | |
|
515 Bridge St Park Rapids MN 56470-1210 | |
| (218) 366-9229 | |
| Not Available |
| Full Name | Lake Country Associates, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 515 Bridge St, Park Rapids, Minnesota |
| Authorized Official Name and Position | Jean Kirchner (CEO) |
| Authorized Official Contact | 2183669229 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Country Associates, Inc. 515 Bridge St Park Rapids MN 56470-1210 Ph: (218) 366-9229 | Lake Country Associates, Inc. 515 Bridge St Park Rapids MN 56470-1210 Ph: (218) 366-9229 |
| NPI Number | 1104151588 |
|---|---|
| Provider Enumeration Date | 10/02/2009 |
| Last Update Date | 02/28/2017 |
| Medicare PECOS PAC ID | 3779610472 |
|---|---|
| Medicare Enrollment ID | O20100429000429 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104151588 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Deborah Jeanne Farrell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912076712 PECOS PAC ID: 8729185491 Enrollment ID: I20070515000464 |
| Provider Name | Jean I Greseth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679587992 PECOS PAC ID: 6002943701 Enrollment ID: I20100429000568 |
| Provider Name | Elissa J Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821219205 PECOS PAC ID: 3870868292 Enrollment ID: I20171010002581 |
| Provider Name | Jessica Rae Croatt Niemi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265653653 PECOS PAC ID: 9436419421 Enrollment ID: I20180213001337 |
| Provider Name | Laura Margaret Hansen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265565642 PECOS PAC ID: 4587926100 Enrollment ID: I20180320000749 |
| Provider Name | Michael Timothy Mobley Finn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437785151 PECOS PAC ID: 0547681157 Enrollment ID: I20200608002473 |
| Provider Name | Vanessa Marie Wananu |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184997710 PECOS PAC ID: 0143631556 Enrollment ID: I20201116001225 |
| Provider Name | Laura Kempnich |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487142006 PECOS PAC ID: 7618368887 Enrollment ID: I20211222001868 |
| Provider Name | Hyacinth R Mosse |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851778104 PECOS PAC ID: 1759765845 Enrollment ID: I20220909000360 |
| Provider Name | Laura Lynn Kirlin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972764454 PECOS PAC ID: 4981076304 Enrollment ID: I20230214000401 |
| Provider Name | Cynthia Ann Rollo-carlson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609450428 PECOS PAC ID: 0840663555 Enrollment ID: I20230228001692 |
| Provider Name | Drew Christopher Jaeger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992353387 PECOS PAC ID: 4183097413 Enrollment ID: I20230307000701 |
| Provider Name | Karen Michelle Hill |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235489089 PECOS PAC ID: 6709238660 Enrollment ID: I20240117000988 |
| Provider Name | Da'nel E Chase |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043653090 PECOS PAC ID: 2365894045 Enrollment ID: I20240221002685 |
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