| Lifestyle Counseling Services | |
|
14162 Commerce Ave Ne Suite 400 Prior Lake MN 55372-1480 | |
| (952) 447-1117 | |
| (952) 447-1116 |
| Full Name | Lifestyle Counseling Services |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 14162 Commerce Ave Ne, Prior Lake, Minnesota |
| Authorized Official Name and Position | William M. Walberg (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9524471117 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifestyle Counseling Services 14162 Commerce Ave Ne Suite 400 Prior Lake MN 55372-1480 Ph: (952) 447-1117 | Lifestyle Counseling Services 14162 Commerce Ave Ne Suite 400 Prior Lake MN 55372-1480 Ph: (952) 447-1117 |
| NPI Number | 1417037060 |
|---|---|
| Provider Enumeration Date | 10/17/2006 |
| Last Update Date | 07/10/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417037060 | NPI | - | NPPES |
| 8451554 | Other | MN | UNITED BEHAVIOR HEALTH |
| NA | Other | MN | CIGNA |
| 103171 | Other | MN | U-CARE |
| 1601 | Other | MN | HEALTH PARTNERS |
| 9105LI | Other | MN | BC/BS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 810953-1 (Minnesota) | Primary |
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