| Mn Mental Health Specialists Pa | |
|
303 Credit Union Dr Ste 12a Isanti MN 55040-4010 | |
| (612) 296-8901 | |
| Not Available |
| Full Name | Mn Mental Health Specialists Pa |
|---|---|
| Speciality | Counselor |
| Location | 303 Credit Union Dr Ste 12a, Isanti, Minnesota |
| Authorized Official Name and Position | Melissa Lynn Martini-tischer (MENTAL HEALTH PROFESSIONAL) |
| Authorized Official Contact | 6122968901 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mn Mental Health Specialists Pa 6971 330th Ln Nw Princeton MN 55371-4930 Ph: (612) 296-8901 | Mn Mental Health Specialists Pa 303 Credit Union Dr Ste 12a Isanti MN 55040-4010 Ph: (612) 296-8901 |
| NPI Number | 1356059687 |
|---|---|
| Provider Enumeration Date | 11/07/2022 |
| Last Update Date | 09/13/2023 |
| Certification Date | 09/13/2023 |
| Medicare PECOS PAC ID | 6608221643 |
|---|---|
| Medicare Enrollment ID | O20231011003917 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356059687 | NPI | - | NPPES |
| 1477706885 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| Provider Name | Kristi M Johnson Zempel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902869340 PECOS PAC ID: 9234167701 Enrollment ID: I20050727000522 |
| Provider Name | Melissa Lynn Martini-tischer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477706885 PECOS PAC ID: 8325493364 Enrollment ID: I20240109001025 |
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