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50 W 2nd St Ste 103 Winona MN 55987-3440 | |
(507) 312-9383 | |
Not Available |
Full Name | |
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Speciality | Counselor |
Location | 50 W 2nd St Ste 103, Winona, Minnesota |
Authorized Official Name and Position | Kelly Rokus (OWNER/COUNSELOR) |
Authorized Official Contact | 5073129383 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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50 W 2nd St Ste 103 Winona MN 55987-3440 Ph: (507) 312-9383 | 50 W 2nd St Ste 103 Winona MN 55987-3440 Ph: (507) 312-9383 |
NPI Number | 1235763814 |
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Provider Enumeration Date | 02/23/2020 |
Last Update Date | 12/15/2023 |
Certification Date | 12/15/2023 |
Medicare PECOS PAC ID | 0143672873 |
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Medicare Enrollment ID | O20240118002377 |
Identifier | Type | State | Issuer |
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1235763814 | NPI | - | NPPES |
Provider Name | Kelly J Rokus |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1942718028 PECOS PAC ID: 3971951591 Enrollment ID: I20240118002491 |
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