| Meraki Legacy Counseling Services | |
|
15 S Minnesota St New Ulm MN 56073-3056 | |
| (507) 276-8383 | |
| Not Available |
| Full Name | Meraki Legacy Counseling Services |
|---|---|
| Speciality | Social Worker |
| Location | 15 S Minnesota St, New Ulm, Minnesota |
| Authorized Official Name and Position | Bonnie Rose Beranek-fortwengler (THERAPIST/OWNER) |
| Authorized Official Contact | 5073280690 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Meraki Legacy Counseling Services 15 S Minnesota St New Ulm MN 56073-3056 Ph: (507) 328-0690 | Meraki Legacy Counseling Services 15 S Minnesota St New Ulm MN 56073-3056 Ph: (507) 276-8383 |
| NPI Number | 1063164531 |
|---|---|
| Provider Enumeration Date | 01/25/2022 |
| Last Update Date | 02/01/2022 |
| Certification Date | 02/01/2022 |
| Medicare PECOS PAC ID | 9234523267 |
|---|---|
| Medicare Enrollment ID | O20220308001299 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063164531 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Bonnie R Beranek-fortwengler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215246640 PECOS PAC ID: 7810179140 Enrollment ID: I20110308000861 |
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