| Lake Minnetonka Counseling | |
|
432 Mill St Suite 201 Long Lake MN 55356-8304 | |
| (612) 386-2311 | |
| Not Available |
| Full Name | Lake Minnetonka Counseling |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 432 Mill St, Long Lake, Minnesota |
| Authorized Official Name and Position | Tara Marie Bauman (THERAPIST) |
| Authorized Official Contact | 6123862311 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Minnetonka Counseling 470 County Road 110 North Minnetrista MN 55364-8315 Ph: (612) 386-2311 | Lake Minnetonka Counseling 432 Mill St Suite 201 Long Lake MN 55356-8304 Ph: (612) 386-2311 |
| NPI Number | 1578835310 |
|---|---|
| Provider Enumeration Date | 02/08/2012 |
| Last Update Date | 02/08/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578835310 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 18016 (Minnesota) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | 18016 (Minnesota) | Primary |
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