| Oak Ridge Center Pllc | |
|
7300 W 147th St Suite 203 Apple Valley MN 55124 | |
| (952) 431-6033 | |
| (952) 431-3225 |
| Full Name | Oak Ridge Center Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7300 W 147th St, Apple Valley, Minnesota |
| Authorized Official Name and Position | Kristi Kay Picken (MS RN CNS VICE PRESIDENT OAK RIDGE) |
| Authorized Official Contact | 9524316033 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oak Ridge Center Pllc 7300 W 147th St Suite 203 Apple Valley MN 55124 Ph: (952) 431-6033 | Oak Ridge Center Pllc 7300 W 147th St Suite 203 Apple Valley MN 55124 Ph: (952) 431-6033 |
| NPI Number | 1730247578 |
|---|---|
| Provider Enumeration Date | 12/05/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 2365339322 |
|---|---|
| Medicare Enrollment ID | O20040303000765 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730247578 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Brielle J Stoyke |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1811988967 PECOS PAC ID: 5597753293 Enrollment ID: I20040503000778 |
| Provider Name | Jill R Toliver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518923499 PECOS PAC ID: 5496669236 Enrollment ID: I20040715000423 |
| Provider Name | Promise C Amajiri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164898953 PECOS PAC ID: 9638486178 Enrollment ID: I20150916002481 |
| Provider Name | Steven C Severson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780060129 PECOS PAC ID: 2961759048 Enrollment ID: I20180719003942 |
| Provider Name | Caitlyn N Rogers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922470152 PECOS PAC ID: 9032445390 Enrollment ID: I20190724001028 |
| Provider Name | Amanda L Tieri |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235762709 PECOS PAC ID: 8123457710 Enrollment ID: I20200402001414 |
| Provider Name | Edward D Meehan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649986233 PECOS PAC ID: 4981066487 Enrollment ID: I20230816000140 |
| Provider Name | Madison Hoffman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639637010 PECOS PAC ID: 2567818685 Enrollment ID: I20231026000686 |
| Provider Name | Shannon Rose Pollreis |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1407211154 PECOS PAC ID: 3870943392 Enrollment ID: I20231226001346 |
| Provider Name | Warren Lemay |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023406550 PECOS PAC ID: 1052754876 Enrollment ID: I20240208003190 |
| Provider Name | Andrew Stumbo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285396754 PECOS PAC ID: 6103274188 Enrollment ID: I20240227001956 |
| Provider Name | Mary E Vanalstine |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861261877 PECOS PAC ID: 9032554290 Enrollment ID: I20240227002810 |
| Provider Name | David Karan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902201312 PECOS PAC ID: 5991006231 Enrollment ID: I20240522002499 |
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