| Minnesota Care Counseling Services, Inc | |
|
3355 Hiawatha Ave Ste 112 Minneapolis MN 55406-2443 | |
| (612) 644-9466 | |
| (800) 933-0968 |
| Full Name | Minnesota Care Counseling Services, Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3355 Hiawatha Ave Ste 112, Minneapolis, Minnesota |
| Authorized Official Name and Position | Hussein Mohamed (PRESIDENT/CEO) |
| Authorized Official Contact | 6126449466 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Minnesota Care Counseling Services, Inc 3355 Hiawatha Ave Ste 112 Minneapolis MN 55406-2443 Ph: (612) 644-9466 | Minnesota Care Counseling Services, Inc 3355 Hiawatha Ave Ste 112 Minneapolis MN 55406-2443 Ph: (612) 644-9466 |
| NPI Number | 1700265964 |
|---|---|
| Provider Enumeration Date | 05/21/2015 |
| Last Update Date | 03/08/2017 |
| Medicare PECOS PAC ID | 4082033089 |
|---|---|
| Medicare Enrollment ID | O20200924000968 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700265964 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 19934 (Minnesota) | Primary |
| 253Z00000X | In Home Supportive Care | 1075365-1-HCBS (Minnesota) | Secondary |
| Provider Name | Michelle M Austin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114391513 PECOS PAC ID: 3577868405 Enrollment ID: I20160301001972 |
| Provider Name | Hallie Lauren Olson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205104494 PECOS PAC ID: 7416288378 Enrollment ID: I20191008002819 |
| Provider Name | George Lindall |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215058649 PECOS PAC ID: 2567881550 Enrollment ID: I20200924000855 |
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