| Sankalpa Therapy And Wellness Center | |
|
5221 Viking Dr Ste 300 Bloomington MN 55435-5323 | |
| (612) 849-4792 | |
| (612) 677-3722 |
| Full Name | Sankalpa Therapy And Wellness Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 5221 Viking Dr Ste 300, Bloomington, Minnesota |
| Authorized Official Name and Position | Erin Elizabeth Shobe (OWNER/PRESIDENT) |
| Authorized Official Contact | 6128494792 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sankalpa Therapy And Wellness Center 5221 Viking Dr Ste 300 Bloomington MN 55435-5323 Ph: (612) 849-4792 | Sankalpa Therapy And Wellness Center 5221 Viking Dr Ste 300 Bloomington MN 55435-5323 Ph: (612) 849-4792 |
| NPI Number | 1659761633 |
|---|---|
| Provider Enumeration Date | 01/29/2015 |
| Last Update Date | 05/17/2024 |
| Certification Date | 05/17/2024 |
| Medicare PECOS PAC ID | 1456893759 |
|---|---|
| Medicare Enrollment ID | O20240601000159 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659761633 | NPI | - | NPPES |
| 1659761633 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 1560 (Minnesota) | Primary |
| Provider Name | Natasha L Isaman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720608110 PECOS PAC ID: 6608295167 Enrollment ID: I20210107001521 |
| Provider Name | Erin E Shobe |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1740409242 PECOS PAC ID: 0446792741 Enrollment ID: I20240601000226 |
| Provider Name | Claire Debenedetto |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1649938317 PECOS PAC ID: 3072055375 Enrollment ID: I20240601000274 |
| Provider Name | Deric R Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093423337 PECOS PAC ID: 1153863451 Enrollment ID: I20240601000294 |
| Provider Name | Elliot Odendahl |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366086290 PECOS PAC ID: 2961944269 Enrollment ID: I20240601000314 |
| Provider Name | Julie Mcmonagle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366876658 PECOS PAC ID: 9830631688 Enrollment ID: I20240607001062 |
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