| Mental Health Collaborative Of Mankato | |
|
1101 N Riverfront Dr Mankato MN 56001-3354 | |
| (507) 779-9872 | |
| Not Available |
| Full Name | Mental Health Collaborative Of Mankato |
|---|---|
| Speciality | Social Worker |
| Location | 1101 N Riverfront Dr, Mankato, Minnesota |
| Authorized Official Name and Position | George W Clements (OWNER) |
| Authorized Official Contact | 5077799872 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mental Health Collaborative Of Mankato Po Box 656 Mankato MN 56002-0656 Ph: (507) 779-9872 | Mental Health Collaborative Of Mankato 1101 N Riverfront Dr Mankato MN 56001-3354 Ph: (507) 779-9872 |
| NPI Number | 1467234377 |
|---|---|
| Provider Enumeration Date | 10/16/2023 |
| Last Update Date | 10/19/2023 |
| Certification Date | 10/19/2023 |
| Medicare PECOS PAC ID | 4688018138 |
|---|---|
| Medicare Enrollment ID | O20240223000203 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467234377 | NPI | - | NPPES |
| Provider Name | George W Clements |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194870881 PECOS PAC ID: 3577578970 Enrollment ID: I20060207000104 |
| Provider Name | Katie Marie Stadheim |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376936047 PECOS PAC ID: 1759608748 Enrollment ID: I20150401001281 |
| Provider Name | Jacqueline A Tohal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659837847 PECOS PAC ID: 7113352022 Enrollment ID: I20200123001724 |
| Provider Name | Katarina L Barrett Krzmarzick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275173445 PECOS PAC ID: 3577993146 Enrollment ID: I20200422001670 |
| Provider Name | Laura C Schultz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699453084 PECOS PAC ID: 8123479029 Enrollment ID: I20240104002787 |
| Provider Name | Katie M Kleinschmidt |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1053758821 PECOS PAC ID: 7214371772 Enrollment ID: I20240223000429 |
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