Mind And Body Counseling | |
15088 22nd Ave Ne Little Falls MN 56345-4199 | |
(320) 630-2782 | |
(888) 892-4587 |
Full Name | Mind And Body Counseling |
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Speciality | Marriage & Family Therapist |
Location | 15088 22nd Ave Ne, Little Falls, Minnesota |
Authorized Official Name and Position | Stephanie Mackissock (OWNER) |
Authorized Official Contact | 3206302782 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mind And Body Counseling 6568 230th St Randall MN 56475-2414 Ph: (320) 630-2782 | Mind And Body Counseling 15088 22nd Ave Ne Little Falls MN 56345-4199 Ph: (320) 630-2782 |
NPI Number | 1912752403 |
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Provider Enumeration Date | 04/18/2024 |
Last Update Date | 12/03/2024 |
Certification Date | 12/03/2024 |
Medicare PECOS PAC ID | 0648706044 |
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Medicare Enrollment ID | O20241209003128 |
Identifier | Type | State | Issuer |
---|---|---|---|
1912752403 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
Provider Name | Stephanie Mackissock |
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Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1750855227 PECOS PAC ID: 2466988860 Enrollment ID: I20241209003255 |
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