| Med City Psychotherapy Llc | |
|
3265 19th St Nw Ste 310 Rochester MN 55901-6786 | |
| (507) 990-2396 | |
| Not Available |
| Full Name | Med City Psychotherapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 3265 19th St Nw Ste 310, Rochester, Minnesota |
| Authorized Official Name and Position | Katelyn Aleshire Olgren (OWNER) |
| Authorized Official Contact | 5079902396 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Med City Psychotherapy Llc 1006 9th Ave Se Rochester MN 55904-5073 Ph: (507) 990-2396 | Med City Psychotherapy Llc 3265 19th St Nw Ste 310 Rochester MN 55901-6786 Ph: (507) 990-2396 |
| NPI Number | 1871291963 |
|---|---|
| Provider Enumeration Date | 02/20/2023 |
| Last Update Date | 01/09/2024 |
| Certification Date | 01/09/2024 |
| Medicare PECOS PAC ID | 9133564248 |
|---|---|
| Medicare Enrollment ID | O20240228003571 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871291963 | NPI | - | NPPES |
| P-136-115-670-910 | Other | MN | DRIVER'S LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Katelyn Adele Aleshire Olgren |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184320632 PECOS PAC ID: 5991178212 Enrollment ID: I20230307000333 |
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