| Mankato Psychology Clinic, Plc | |
|
209 S 2nd St Suite 306 Mankato MN 56001-3626 | |
| (507) 387-1350 | |
| (507) 387-6605 |
| Full Name | Mankato Psychology Clinic, Plc |
|---|---|
| Speciality | Counselor |
| Location | 209 S 2nd St, Mankato, Minnesota |
| Authorized Official Name and Position | Peggysue Hesse (OWNER, PARTNER) |
| Authorized Official Contact | 5073871350 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mankato Psychology Clinic, Plc 209 S 2nd St Suite 306 Mankato MN 56001-3626 Ph: (507) 387-1350 | Mankato Psychology Clinic, Plc 209 S 2nd St Suite 306 Mankato MN 56001-3626 Ph: (507) 387-1350 |
| NPI Number | 1679628192 |
|---|---|
| Provider Enumeration Date | 01/24/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0941214381 |
|---|---|
| Medicare Enrollment ID | O20060206000542 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679628192 | NPI | - | NPPES |
| 81G62MA | Other | MN | BLUE CROSS |
| 114490 | Other | MN | UCARE |
| 6H521MA | Other | MN | BLUE CROSS |
| 6H520MA | Other | MN | BLUE CROSS |
| 155H1MA | Other | MN | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 1926616 (Minnesota) | Primary |
| Provider Name | Allan J Coursol |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932254521 PECOS PAC ID: 5193739548 Enrollment ID: I20120214000063 |
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