| Practical Therapy Llc | |
|
570 Asbury St Suite 206 Saint Paul MN 55104-1849 | |
| (612) 760-7818 | |
| (651) 212-4149 |
| Full Name | Practical Therapy Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 570 Asbury St, Saint Paul, Minnesota |
| Authorized Official Name and Position | Jeanne Lynn Fischer (LICSW, OWNER) |
| Authorized Official Contact | 6127607818 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Practical Therapy Llc 570 Asbury St Suite 206 Saint Paul MN 55104-1849 Ph: (612) 760-7818 | Practical Therapy Llc 570 Asbury St Suite 206 Saint Paul MN 55104-1849 Ph: (612) 760-7818 |
| NPI Number | 1134528557 |
|---|---|
| Provider Enumeration Date | 08/21/2014 |
| Last Update Date | 08/21/2014 |
| Medicare PECOS PAC ID | 2860718939 |
|---|---|
| Medicare Enrollment ID | O20150715001553 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134528557 | NPI | - | NPPES |
| 246900600 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 13825 (Minnesota) | Primary |
| Provider Name | Jeanne L Fischer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740401298 PECOS PAC ID: 1456414176 Enrollment ID: I20150715001784 |
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