Minnesota Online Counseling Llc | |
1310 Highway 96 E Suite 104c White Bear Lake MN 55110-3624 | |
(651) 336-6942 | |
Not Available |
Full Name | Minnesota Online Counseling Llc |
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Speciality | Marriage & Family Therapist |
Location | 1310 Highway 96 E, White Bear Lake, Minnesota |
Authorized Official Name and Position | David Halper (MANAGING MEMBER) |
Authorized Official Contact | 6513366942 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Minnesota Online Counseling Llc 6808 Upper 28th St N Oakdale MN 55128-3833 Ph: (651) 336-6942 | Minnesota Online Counseling Llc 1310 Highway 96 E Suite 104c White Bear Lake MN 55110-3624 Ph: (651) 336-6942 |
NPI Number | 1609255694 |
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Provider Enumeration Date | 05/22/2015 |
Last Update Date | 05/22/2015 |
Medicare PECOS PAC ID | 3072849207 |
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Medicare Enrollment ID | O20190725003486 |
Identifier | Type | State | Issuer |
---|---|---|---|
1609255694 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
Provider Name | David Phillip Halper |
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Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1316003874 PECOS PAC ID: 2264564160 Enrollment ID: I20240408000133 |
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