| Pinnacle Behavioral Healthcare, Llc | |
|
6600 France Ave S Ste 415 Edina MN 55435-1804 | |
| (952) 303-6832 | |
| (952) 303-3434 |
| Full Name | Pinnacle Behavioral Healthcare, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6600 France Ave S Ste 415, Edina, Minnesota |
| Authorized Official Name and Position | Olukayode O Awosika (MEDICAL DIRECTOR/ADULT PSYCHIATRIST) |
| Authorized Official Contact | 9523036832 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pinnacle Behavioral Healthcare, Llc 6600 France Ave S Ste 415 Edina MN 55435-1804 Ph: (952) 303-6832 | Pinnacle Behavioral Healthcare, Llc 6600 France Ave S Ste 415 Edina MN 55435-1804 Ph: (952) 303-6832 |
| NPI Number | 1356629232 |
|---|---|
| Provider Enumeration Date | 07/27/2011 |
| Last Update Date | 01/02/2020 |
| Certification Date | 01/02/2020 |
| Medicare PECOS PAC ID | 3274793807 |
|---|---|
| Medicare Enrollment ID | O20120320000021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356629232 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 261QM0850X | Clinic/center - Adult Mental Health | 2152558 (Minnesota) | Primary |
| Provider Name | Olukayode O Awosika |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073539953 PECOS PAC ID: 3072578244 Enrollment ID: I20041130000239 |
| Provider Name | Stephanie R Sligo Baker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861543894 PECOS PAC ID: 2769667443 Enrollment ID: I20110421000868 |
| Provider Name | Cassidy M Furey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679837926 PECOS PAC ID: 3274770953 Enrollment ID: I20130517000052 |
| Provider Name | Pennie E Bucilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104225499 PECOS PAC ID: 3971814245 Enrollment ID: I20150612002432 |
| Provider Name | Traci L Hakanson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225166135 PECOS PAC ID: 0840590634 Enrollment ID: I20151201000490 |
| Provider Name | Mary Jo Guest |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912362948 PECOS PAC ID: 2365745759 Enrollment ID: I20160119000949 |
| Provider Name | Sadiya S Bule |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154876233 PECOS PAC ID: 6709138522 Enrollment ID: I20181005001811 |
| Provider Name | Tamara Kittleson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194379214 PECOS PAC ID: 5890116701 Enrollment ID: I20200602000654 |
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