| Maple Grove Counseling Center Pa | |
|
13700 83rd Way Ste 205 Maple Grove MN 55369-7015 | |
| (763) 494-8699 | |
| (763) 494-8797 |
| Full Name | Maple Grove Counseling Center Pa |
|---|---|
| Speciality | Psychologist |
| Location | 13700 83rd Way, Maple Grove, Minnesota |
| Authorized Official Name and Position | Ardith Ann Messicci (LICENSED PSYCHOLOGIST OWNER) |
| Authorized Official Contact | 7634948699 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maple Grove Counseling Center Pa 13700 83rd Way Ste 205 Maple Grove MN 55369-7015 Ph: (763) 494-8699 | Maple Grove Counseling Center Pa 13700 83rd Way Ste 205 Maple Grove MN 55369-7015 Ph: (763) 494-8699 |
| NPI Number | 1164496071 |
|---|---|
| Provider Enumeration Date | 02/15/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164496071 | NPI | - | NPPES |
| 3H755ME | Other | MN | BCBS |
| 88297 | Other | MN | ARAZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | LP0951 (Minnesota) | Primary |
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