| Life Skills Institute & Clinic, Inc. | |
|
3937 Orchid Ln N Plymouth MN 55446-3281 | |
| (763) 476-1031 | |
| (763) 476-0181 |
| Full Name | Life Skills Institute & Clinic, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 3937 Orchid Ln N, Plymouth, Minnesota |
| Authorized Official Name and Position | Margaret Green (LICENSEED PSYCHOLOGIST) |
| Authorized Official Contact | 7634761031 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Skills Institute & Clinic, Inc. 3937 Orchid Ln N Plymouth MN 55446-3281 Ph: (763) 476-1031 | Life Skills Institute & Clinic, Inc. 3937 Orchid Ln N Plymouth MN 55446-3281 Ph: (763) 476-1031 |
| NPI Number | 1528145281 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6901953488 |
|---|---|
| Medicare Enrollment ID | O20090421000250 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528145281 | NPI | - | NPPES |
| 05915GR | Other | MN | BLUE CROSS BLUE SHIELD |
| 41147 | Other | MN | PREFERRED ONE PROV ID |
| 6181110 | Other | MN | MEDICA PROVIDER ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | LP0148 (Minnesota) | Primary |
| Provider Name | Margaret A Green |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093924789 PECOS PAC ID: 4284781766 Enrollment ID: I20090421000241 |
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