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1611 County Road B W Ste 202 Roseville MN 55113-4053 | |
| (651) 300-1112 | |
| (651) 358-2996 |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1611 County Road B W Ste 202, Roseville, Minnesota |
| Authorized Official Name and Position | Layla Asamarai (OWNER) |
| Authorized Official Contact | 6513001112 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1611 County Road B W Ste 202 Roseville MN 55113-4053 Ph: (651) 300-1112 | 1611 County Road B W Ste 202 Roseville MN 55113-4053 Ph: (651) 300-1112 |
| NPI Number | 1588015168 |
|---|---|
| Provider Enumeration Date | 06/25/2016 |
| Last Update Date | 01/29/2020 |
| Certification Date | 01/29/2020 |
| Medicare PECOS PAC ID | 3678816402 |
|---|---|
| Medicare Enrollment ID | O20190520001183 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588015168 | NPI | - | NPPES |
| 1588015168 | Medicaid | MN |
| Provider Name | Layla A Asamarai |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205287885 PECOS PAC ID: 9032497672 Enrollment ID: I20161102000016 |
| Provider Name | Kelsey J Mccarston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518439702 PECOS PAC ID: 1254679699 Enrollment ID: I20190211002507 |
| Provider Name | Ruth Marie Swartwood |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992179501 PECOS PAC ID: 6709289051 Enrollment ID: I20210723000578 |
| Provider Name | Gregory R Simonson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942850003 PECOS PAC ID: 5799163713 Enrollment ID: I20220603001306 |
| Provider Name | Maria Karim Siddiqui |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265023907 PECOS PAC ID: 3274076302 Enrollment ID: I20240618001647 |
| Provider Name | Kifaya Bishop |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588358725 PECOS PAC ID: 5193263879 Enrollment ID: I20240813001200 |
| Provider Name | Christa Hoel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790261527 PECOS PAC ID: 3577001221 Enrollment ID: I20240813003704 |
| Provider Name | Zehra Ansari |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1336237114 PECOS PAC ID: 8628393097 Enrollment ID: I20240822002850 |
| Provider Name | Kunga Norzom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669166815 PECOS PAC ID: 1355882580 Enrollment ID: I20240916001488 |
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Creative Thinkers Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2499 Rice St Ste 76, Roseville, MN 55113 Phone: 617-206-0332 | |
Soaringhigh Aba Mn Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2355 Highway 36 W Ste 400, Roseville, MN 55113 Phone: 845-300-2769 | |
Axis Alternatives Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2345 Rice St Ste 112, Roseville, MN 55113 Phone: 651-357-1100 Fax: 651-357-1100 | |
Nice Healthcare Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2786 Fairview Ave N, Roseville, MN 55113 Phone: 651-334-0720 | |
Path2possibilities Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3050 Old Highway 8 Apt 213, Roseville, MN 55113 Phone: 952-769-3159 |