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12940 Harriet Ave S Ste 260e Burnsville MN 55337-4138 | |
| (651) 300-9493 | |
| (651) 927-0210 |
| Full Name | |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 12940 Harriet Ave S Ste 260e, Burnsville, Minnesota |
| Authorized Official Name and Position | Celia Smith (OWNER/OPERATOR/PSYCHOTHERAPIST) |
| Authorized Official Contact | 6513009493 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
12940 Harriet Ave S Ste 260e Burnsville MN 55337-4138 Ph: (651) 300-9493 | 12940 Harriet Ave S Ste 260e Burnsville MN 55337-4138 Ph: (651) 300-9493 |
| NPI Number | 1033876495 |
|---|---|
| Provider Enumeration Date | 11/19/2021 |
| Last Update Date | 01/17/2024 |
| Certification Date | 01/15/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033876495 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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