| Poplar Grove Counseling, Pllp | |
|
3011 36th Ave S Suite 9 Minneapolis MN 55406-2796 | |
| (612) 578-5181 | |
| Not Available |
| Full Name | Poplar Grove Counseling, Pllp |
|---|---|
| Speciality | Social Worker |
| Location | 3011 36th Ave S, Minneapolis, Minnesota |
| Authorized Official Name and Position | Alissa Dawn Kaasa (THERAPIST, MANAGING PARTNER) |
| Authorized Official Contact | 6125785181 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Poplar Grove Counseling, Pllp 3011 36th Ave S Suite 9 Minneapolis MN 55406-2796 Ph: (651) 335-3799 | Poplar Grove Counseling, Pllp 3011 36th Ave S Suite 9 Minneapolis MN 55406-2796 Ph: (612) 578-5181 |
| NPI Number | 1083085989 |
|---|---|
| Provider Enumeration Date | 10/18/2015 |
| Last Update Date | 02/18/2016 |
| Medicare PECOS PAC ID | 8426353145 |
|---|---|
| Medicare Enrollment ID | O20160217002463 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083085989 | NPI | - | NPPES |
| Provider Name | Alissa D Kaasa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700265246 PECOS PAC ID: 1658676143 Enrollment ID: I20160222000615 |
| Provider Name | Sally R Vanerstrom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114065810 PECOS PAC ID: 6002111564 Enrollment ID: I20200207000583 |
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