| Life On Purpose Counseling & Neurofeedback Inc | |
|
312 County Road D E Little Canada MN 55117-1275 | |
| (651) 600-7876 | |
| Not Available |
| Full Name | Life On Purpose Counseling & Neurofeedback Inc |
|---|---|
| Speciality | Social Worker |
| Location | 312 County Road D E, Little Canada, Minnesota |
| Authorized Official Name and Position | Dannielle Marie Fladten White (PRESIDENT/PSYCHOTHERAPIST) |
| Authorized Official Contact | 6516007876 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life On Purpose Counseling & Neurofeedback Inc 312 County Road D E Little Canada MN 55117-1275 Ph: (651) 600-7876 | Life On Purpose Counseling & Neurofeedback Inc 312 County Road D E Little Canada MN 55117-1275 Ph: (651) 600-7876 |
| NPI Number | 1942708573 |
|---|---|
| Provider Enumeration Date | 01/29/2018 |
| Last Update Date | 03/25/2018 |
| Medicare PECOS PAC ID | 2466712997 |
|---|---|
| Medicare Enrollment ID | O20180201001339 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942708573 | NPI | - | NPPES |
| 1942708573 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 18463 (Minnesota) | Primary |
| Provider Name | Bridget B Leonard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316368616 PECOS PAC ID: 3678704061 Enrollment ID: I20140328000060 |
| Provider Name | Dannielle M White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114353174 PECOS PAC ID: 2466761036 Enrollment ID: I20151021002222 |
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