| Lighthouse Child & Family Services | |
|
17641 55th St Ne Foley MN 56329-9761 | |
| (320) 237-6252 | |
| Not Available |
| Full Name | Lighthouse Child & Family Services |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 17641 55th St Ne, Foley, Minnesota |
| Authorized Official Name and Position | Julie Ann Nybakke-hanenburg (OWNER) |
| Authorized Official Contact | 3202376252 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Child & Family Services 17641 55th St Ne Foley MN 56329-9761 Ph: (320) 237-6252 | Lighthouse Child & Family Services 17641 55th St Ne Foley MN 56329-9761 Ph: (320) 237-6252 |
| NPI Number | 1689861197 |
|---|---|
| Provider Enumeration Date | 09/28/2007 |
| Last Update Date | 09/28/2007 |
| Medicare PECOS PAC ID | 1850571795 |
|---|---|
| Medicare Enrollment ID | O20110209000428 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689861197 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 15603 (Minnesota) | Primary |
| Provider Name | Julie A Hanenburg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710108790 PECOS PAC ID: 2466632302 Enrollment ID: I20110209000560 |
| Provider Name | Jennifer J Goerger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740416932 PECOS PAC ID: 9931389889 Enrollment ID: I20110209000590 |
| Provider Name | Raeann C Hagen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881133718 PECOS PAC ID: 3577974286 Enrollment ID: I20201202001351 |
| Provider Name | Amy Jo Boldt |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1669840948 PECOS PAC ID: 4981048014 Enrollment ID: I20240216002695 |
| Provider Name | Noel Willis |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1487277034 PECOS PAC ID: 2062858111 Enrollment ID: I20240311003764 |
| Provider Name | Ahnnica Jane Lambrides Baade |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104318922 PECOS PAC ID: 3779920046 Enrollment ID: I20240321003313 |
| Provider Name | Amber Hosie |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1780303040 PECOS PAC ID: 2567809320 Enrollment ID: I20240328001817 |
| Provider Name | Kelsey Ann Gruba |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1598329229 PECOS PAC ID: 6901245505 Enrollment ID: I20240416001087 |
| Provider Name | Elizabeth A Szybatka |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285141648 PECOS PAC ID: 6608215819 Enrollment ID: I20240422000865 |
| Provider Name | Deborah Hannah Gault |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083464804 PECOS PAC ID: 6002255007 Enrollment ID: I20240423002114 |
| Provider Name | Brittany Ann Bemboom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104682632 PECOS PAC ID: 0143660456 Enrollment ID: I20240503001771 |
Journey Through Mental Health And Personal Wellness Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 Broadway Ave N, Foley, MN 56329 Phone: 320-200-4151 Fax: 218-264-8254 |