| Pathways To Wellness Minnesota Ltd. | |
|
1409 Willow St Ste 109 Minneapolis MN 55403-2241 | |
| (612) 474-1700 | |
| (612) 474-1710 |
| Full Name | Pathways To Wellness Minnesota Ltd. |
|---|---|
| Speciality | Social Worker |
| Location | 1409 Willow St Ste 109, Minneapolis, Minnesota |
| Authorized Official Name and Position | Jennifer Ann Baumgardner Barnes (PRESIDENT AND PROVIDER) |
| Authorized Official Contact | 6124741700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pathways To Wellness Minnesota Ltd. 1409 Willow St Ste 109 Minneapolis MN 55403-2241 Ph: (612) 474-1700 | Pathways To Wellness Minnesota Ltd. 1409 Willow St Ste 109 Minneapolis MN 55403-2241 Ph: (612) 474-1700 |
| NPI Number | 1306260005 |
|---|---|
| Provider Enumeration Date | 02/15/2014 |
| Last Update Date | 09/03/2020 |
| Certification Date | 09/03/2020 |
| Medicare PECOS PAC ID | 2961634670 |
|---|---|
| Medicare Enrollment ID | O20201021001164 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306260005 | NPI | - | NPPES |
| 9000152564 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | 1681 (Colorado) | Secondary |
| Provider Name | Jennifer Baumgardner Barnes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184802621 PECOS PAC ID: 3476601303 Enrollment ID: I20090504000485 |
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