| Old Growth Healing Llc | |
|
220 Division St S Ste 2 Northfield MN 55057-2046 | |
| (952) 457-3469 | |
| Not Available |
| Full Name | Old Growth Healing Llc |
|---|---|
| Speciality | Social Worker |
| Location | 220 Division St S Ste 2, Northfield, Minnesota |
| Authorized Official Name and Position | Katie Jacobi (OWNER/PSYCHOTHERAPIST) |
| Authorized Official Contact | 9524573469 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Old Growth Healing Llc 220 Division St S Northfield MN 55057-2046 Ph: (952) 457-3469 | Old Growth Healing Llc 220 Division St S Ste 2 Northfield MN 55057-2046 Ph: (952) 457-3469 |
| NPI Number | 1659064293 |
|---|---|
| Provider Enumeration Date | 05/30/2023 |
| Last Update Date | 05/30/2023 |
| Certification Date | 05/30/2023 |
| Medicare PECOS PAC ID | 9739548876 |
|---|---|
| Medicare Enrollment ID | O20230707000036 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659064293 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Katie Jean Jacobi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164962957 PECOS PAC ID: 8123304417 Enrollment ID: I20171114001378 |
Daniel Dimick, Ma, Lp, Lmft, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 105 4th St E Ste 304, Northfield, MN 55057 Phone: 507-645-6575 Fax: 507-645-7822 | |
Tena Roethle Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 400 Washington St Ste 229, Northfield, MN 55057 Phone: 507-951-8500 | |
Centered Practice Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 401 Division St S, Suite C, Northfield, MN 55057 Phone: 507-649-7294 | |
Create Meaning Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1211 Winona St, Northfield, MN 55057 Phone: 507-350-7785 | |
Secure Base Counseling Center Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 570 Professional Dr, Northfield, MN 55057 Phone: 507-301-3412 | |
Stacey Klempnauer Msw, Licsw Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 402 Washington St, Northfield, MN 55057 Phone: 507-645-0444 | |
Shelley K Hansen, Lsw, Ma, Lp, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 105 East Fourth Street, Suite 302, Northfield, MN 55057 Phone: 612-532-6741 |