| Nuway Mental Health Clinic | |
|
2217 Nicollet Ave Minneapolis MN 55404-3382 | |
| (612) 767-0313 | |
| (612) 767-0301 |
| Full Name | Nuway Mental Health Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 2217 Nicollet Ave, Minneapolis, Minnesota |
| Authorized Official Name and Position | Thomas Meier (CFO) |
| Authorized Official Contact | 6126184888 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nuway Mental Health Clinic 2217 Nicollet Ave Minneapolis MN 55404-3382 Ph: (763) 226-8397 | Nuway Mental Health Clinic 2217 Nicollet Ave Minneapolis MN 55404-3382 Ph: (612) 767-0313 |
| NPI Number | 1013608405 |
|---|---|
| Provider Enumeration Date | 05/16/2023 |
| Last Update Date | 09/17/2024 |
| Certification Date | 09/17/2024 |
| Medicare PECOS PAC ID | 4587108055 |
|---|---|
| Medicare Enrollment ID | O20240626001623 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013608405 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Susan Hoisington |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104974674 PECOS PAC ID: 2163555798 Enrollment ID: I20101101000438 |
| Provider Name | Angelica M Stoltz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396272159 PECOS PAC ID: 4284903931 Enrollment ID: I20170712000438 |
| Provider Name | Kenneth Lewis Roberts |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740503556 PECOS PAC ID: 9830633304 Enrollment ID: I20240626001932 |
| Provider Name | Lindsay Gephart |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740746007 PECOS PAC ID: 7719421114 Enrollment ID: I20240626002860 |
| Provider Name | Jamie Lee Stubler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528661519 PECOS PAC ID: 2668916073 Enrollment ID: I20240626003376 |
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