Lakes Counseling Pllc | |
507 18th Street Suite A Spirit Lake IA 51360 | |
(512) 230-3919 | |
Not Available |
Full Name | Lakes Counseling Pllc |
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Speciality | Social Worker |
Location | 507 18th Street Suite A, Spirit Lake, Iowa |
Authorized Official Name and Position | Rachel Wassenaar (OWNER/OUTPT THERAPIST) |
Authorized Official Contact | 5122303919 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Lakes Counseling Pllc 507 18th Street Suite A Spirit Lake IA 51360 Ph: (512) 230-3919 | Lakes Counseling Pllc 507 18th Street Suite A Spirit Lake IA 51360 Ph: (512) 230-3919 |
NPI Number | 1831758002 |
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Provider Enumeration Date | 06/11/2019 |
Last Update Date | 06/11/2019 |
Medicare PECOS PAC ID | 6406284819 |
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Medicare Enrollment ID | O20200318001907 |
Identifier | Type | State | Issuer |
---|---|---|---|
1831758002 | NPI | - | NPPES |
1427280775 | Medicaid | IA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Rachel L Wassenaar |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1427280775 PECOS PAC ID: 0941523930 Enrollment ID: I20141224000202 |
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