| Prairiecare Medical Group | |
|
7616 Currell Blvd Suite 100 Woodbury MN 55125-2290 | |
| (651) 259-9700 | |
| (651) 259-9730 |
| Full Name | Prairiecare Medical Group |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 7616 Currell Blvd, Woodbury, Minnesota |
| Authorized Official Name and Position | Stephen Roger Setterberg (PRESIDENT) |
| Authorized Official Contact | 6512599707 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prairiecare Medical Group 7616 Currell Blvd Suite 100 Woodbury MN 55125-2290 Ph: (651) 259-9700 | Prairiecare Medical Group 7616 Currell Blvd Suite 100 Woodbury MN 55125-2290 Ph: (651) 259-9700 |
| NPI Number | 1881849586 |
|---|---|
| Provider Enumeration Date | 11/21/2008 |
| Last Update Date | 02/16/2009 |
| Medicare PECOS PAC ID | 9335288786 |
|---|---|
| Medicare Enrollment ID | O20091125000166 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881849586 | NPI | - | NPPES |
| Provider Name | Raymond J Kennedy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871576223 PECOS PAC ID: 9234186750 Enrollment ID: I20050406000423 |
| Provider Name | Paul T Richardson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750369088 PECOS PAC ID: 8224085667 Enrollment ID: I20050407000202 |
| Provider Name | Melissa K Coble |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780613596 PECOS PAC ID: 7911934849 Enrollment ID: I20050722000390 |
| Provider Name | Susan M Buelow |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1265535876 PECOS PAC ID: 4183623093 Enrollment ID: I20061204000076 |
| Provider Name | Barbara S Vallecillo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588724496 PECOS PAC ID: 7416959663 Enrollment ID: I20070201000246 |
| Provider Name | Sreejaya Veluvali |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568462570 PECOS PAC ID: 0749243624 Enrollment ID: I20070728000012 |
| Provider Name | Anna Igorevna Yurchenko |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326189879 PECOS PAC ID: 7416048848 Enrollment ID: I20070814000355 |
| Provider Name | Marc E Mooney |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104960061 PECOS PAC ID: 1951481456 Enrollment ID: I20080109000868 |
| Provider Name | Kim D Holtmeier |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306873237 PECOS PAC ID: 5799734323 Enrollment ID: I20080501000546 |
| Provider Name | Stephen Roger Setterberg |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255493565 PECOS PAC ID: 0345288452 Enrollment ID: I20091203000632 |
| Provider Name | Kristin M Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992029300 PECOS PAC ID: 8820129448 Enrollment ID: I20100625000785 |
| Provider Name | Heidi L Arnold |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346395878 PECOS PAC ID: 4183819501 Enrollment ID: I20101111000515 |
| Provider Name | Michelle M Garay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023288958 PECOS PAC ID: 4789866377 Enrollment ID: I20110302000841 |
| Provider Name | Prachi Agarwala |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073647863 PECOS PAC ID: 9830362961 Enrollment ID: I20111104000294 |
| Provider Name | Michael S Olaughlin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790878957 PECOS PAC ID: 1850437823 Enrollment ID: I20120105000690 |
| Provider Name | Sandra M Quinn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710279369 PECOS PAC ID: 7517107964 Enrollment ID: I20130708000177 |
| Provider Name | Andrea Jean Nelsen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043442700 PECOS PAC ID: 0749423770 Enrollment ID: I20130823000519 |
| Provider Name | Erica L Zielin-wurm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306101357 PECOS PAC ID: 1052547676 Enrollment ID: I20131203001838 |
| Provider Name | Jacob Kerbeshian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831280635 PECOS PAC ID: 1052402781 Enrollment ID: I20131204001131 |
| Provider Name | Laura S Stegenga |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154756906 PECOS PAC ID: 0143457473 Enrollment ID: I20131212000888 |
| Provider Name | Jill M Barger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427480474 PECOS PAC ID: 9638306764 Enrollment ID: I20131218000319 |
| Provider Name | Keimi E Umezu |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861737009 PECOS PAC ID: 2860622941 Enrollment ID: I20140312000089 |
| Provider Name | Suzanne G Jasberg |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679891196 PECOS PAC ID: 0941426043 Enrollment ID: I20140725001548 |
| Provider Name | Jacob J Wilson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265871701 PECOS PAC ID: 9931341278 Enrollment ID: I20140821000325 |
| Provider Name | Brent G Nelson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275825945 PECOS PAC ID: 9436471992 Enrollment ID: I20141211001630 |
| Provider Name | Amy L Swingle |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649678848 PECOS PAC ID: 6204152952 Enrollment ID: I20150224001416 |
| Provider Name | Sarah R Damerow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659741486 PECOS PAC ID: 2769783646 Enrollment ID: I20151218000042 |
| Provider Name | Jamie L Giles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396100046 PECOS PAC ID: 2264737998 Enrollment ID: I20160218000078 |
| Provider Name | Sunil Mehta |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699979823 PECOS PAC ID: 6507014099 Enrollment ID: I20160809002641 |
| Provider Name | Rebekah Nicole Camacho |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1326577669 PECOS PAC ID: 3779852470 Enrollment ID: I20170712002345 |
| Provider Name | Kelsey L Gilles |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033557285 PECOS PAC ID: 3072829621 Enrollment ID: I20171121000497 |
| Provider Name | Kristen A Svendahl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952849580 PECOS PAC ID: 9830456169 Enrollment ID: I20171122000011 |
| Provider Name | Erica L M Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710409495 PECOS PAC ID: 1153688163 Enrollment ID: I20171129003128 |
| Provider Name | Rena J Sugarbaker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881915809 PECOS PAC ID: 1456500396 Enrollment ID: I20171204002525 |
| Provider Name | Sarah E Tague |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861909012 PECOS PAC ID: 9830453679 Enrollment ID: I20180503000873 |
| Provider Name | Kaia Elizabeth Lundin Scales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265910889 PECOS PAC ID: 0547510117 Enrollment ID: I20180830003340 |
| Provider Name | Laura H Dabruzzi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073969390 PECOS PAC ID: 1254682768 Enrollment ID: I20180922000115 |
| Provider Name | Ali R Samikoglu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295121275 PECOS PAC ID: 5698073401 Enrollment ID: I20190711000915 |
| Provider Name | Emily Jacobsma |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063901338 PECOS PAC ID: 0244668309 Enrollment ID: I20200324001143 |
| Provider Name | Justin D Graham |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720244163 PECOS PAC ID: 8628117280 Enrollment ID: I20200701002716 |
| Provider Name | Jessie F Sorvaag Marg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558999508 PECOS PAC ID: 3072936616 Enrollment ID: I20200715000132 |
| Provider Name | Lindsay A Rahkola |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679942130 PECOS PAC ID: 8921425570 Enrollment ID: I20200902000367 |
| Provider Name | Matthew Adams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235583550 PECOS PAC ID: 9032402367 Enrollment ID: I20200917000069 |
| Provider Name | Michael L Richardson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447312251 PECOS PAC ID: 6103236179 Enrollment ID: I20201103000031 |
| Provider Name | Conor Quinn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952947384 PECOS PAC ID: 3274963301 Enrollment ID: I20201201003088 |
| Provider Name | Evy C Hultgren |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104433416 PECOS PAC ID: 4880007434 Enrollment ID: I20201229000817 |
| Provider Name | Amy L Roethler |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1073113908 PECOS PAC ID: 5193138261 Enrollment ID: I20210108002174 |
| Provider Name | Kathryn A Fleuriet |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578948675 PECOS PAC ID: 4981012663 Enrollment ID: I20210419000455 |
| Provider Name | Jessica Villery |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1659850550 PECOS PAC ID: 0840692083 Enrollment ID: I20210712001562 |
| Provider Name | Kailey M Everett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447830898 PECOS PAC ID: 4385047778 Enrollment ID: I20210722001775 |
| Provider Name | Rachael A Juba |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1871036129 PECOS PAC ID: 5991100463 Enrollment ID: I20210820002039 |
| Provider Name | Hannah Chau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992223465 PECOS PAC ID: 2668870783 Enrollment ID: I20211004002581 |
| Provider Name | Sarah Burns |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093075566 PECOS PAC ID: 8628476397 Enrollment ID: I20211011000861 |
| Provider Name | Katie Solberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740546993 PECOS PAC ID: 6709274608 Enrollment ID: I20211026002435 |
| Provider Name | Forest William Juvland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518547512 PECOS PAC ID: 8325438161 Enrollment ID: I20211209001058 |
| Provider Name | Kelsey Menehan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376133983 PECOS PAC ID: 5890172845 Enrollment ID: I20220513001106 |
| Provider Name | Rachel J Lindemann |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1720726086 PECOS PAC ID: 8527444371 Enrollment ID: I20220930001157 |
| Provider Name | Jordan Madden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699323733 PECOS PAC ID: 1951787514 Enrollment ID: I20221005000649 |
| Provider Name | Alice Ping Gu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649700741 PECOS PAC ID: 9234408576 Enrollment ID: I20221114000097 |
| Provider Name | Jennifer E Egeland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083131197 PECOS PAC ID: 5698144467 Enrollment ID: I20221219000314 |
| Provider Name | Laura Elizabeth Pekuri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003563446 PECOS PAC ID: 9638548381 Enrollment ID: I20221220000597 |
| Provider Name | Rachel G Kullas |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1588362404 PECOS PAC ID: 3072988591 Enrollment ID: I20230413001982 |
| Provider Name | Ciara Hildebrandt |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1831899947 PECOS PAC ID: 3274998588 Enrollment ID: I20230420000210 |
| Provider Name | Megan Krippner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932894714 PECOS PAC ID: 1658737861 Enrollment ID: I20230512002458 |
| Provider Name | Nicholas Austin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831455211 PECOS PAC ID: 6800199183 Enrollment ID: I20230601000822 |
| Provider Name | Signe M Midelfort-hector |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073203642 PECOS PAC ID: 1254792955 Enrollment ID: I20230727002337 |
| Provider Name | Nathan Koranda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174200356 PECOS PAC ID: 0840652897 Enrollment ID: I20230808003519 |
| Provider Name | Tiffany Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679945117 PECOS PAC ID: 9234584665 Enrollment ID: I20231004003859 |
| Provider Name | Shawna Geisler Childs |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1114631157 PECOS PAC ID: 0345695623 Enrollment ID: I20231005001993 |
| Provider Name | Molly M Erdmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700597465 PECOS PAC ID: 7012362924 Enrollment ID: I20231012003178 |
| Provider Name | Kayla Roper |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1497434682 PECOS PAC ID: 9436505310 Enrollment ID: I20231030000396 |
| Provider Name | Daniel Monserud |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306555487 PECOS PAC ID: 1557717451 Enrollment ID: I20231030001331 |
| Provider Name | Maria Andersen Keeler |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1174765242 PECOS PAC ID: 4385095850 Enrollment ID: I20240109002353 |
| Provider Name | Bridget Dobie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740060813 PECOS PAC ID: 1759734437 Enrollment ID: I20240130000130 |
| Provider Name | Kari Reinhart |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1841410859 PECOS PAC ID: 3577908870 Enrollment ID: I20240227001477 |
| Provider Name | Suzanne Derheim |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1548709140 PECOS PAC ID: 6709221054 Enrollment ID: I20240227002246 |
| Provider Name | Gerald Schwanke |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1922436716 PECOS PAC ID: 4284079542 Enrollment ID: I20240227002494 |
| Provider Name | Kathleen Faust |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487029047 PECOS PAC ID: 6002251261 Enrollment ID: I20240227002958 |
| Provider Name | Kristi Brown |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1811107766 PECOS PAC ID: 5294141800 Enrollment ID: I20240227004007 |
| Provider Name | Angela Zachrison |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1720385735 PECOS PAC ID: 5890130983 Enrollment ID: I20240228003035 |
| Provider Name | Harold D Saksa |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124590948 PECOS PAC ID: 5294172656 Enrollment ID: I20240320002995 |
| Provider Name | Dewina Anderson Kraus |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1205126927 PECOS PAC ID: 0244677169 Enrollment ID: I20240327000390 |
| Provider Name | Allyson Waninger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093332488 PECOS PAC ID: 5092152926 Enrollment ID: I20240327000664 |
| Provider Name | Jillian Ellingson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891027454 PECOS PAC ID: 5597102319 Enrollment ID: I20240328000496 |
| Provider Name | Gene M Nisja |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1528103595 PECOS PAC ID: 4486091246 Enrollment ID: I20240328001783 |
| Provider Name | Denise B Rodiles |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1265084735 PECOS PAC ID: 2264879022 Enrollment ID: I20240328001922 |
| Provider Name | Ann E Markovich |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1578813010 PECOS PAC ID: 8325486160 Enrollment ID: I20240329001386 |
| Provider Name | Lisa Cross |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1871519397 PECOS PAC ID: 8325486061 Enrollment ID: I20240401002476 |
| Provider Name | Samuel O Frank |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154964294 PECOS PAC ID: 2961840855 Enrollment ID: I20240411000947 |
| Provider Name | Meghan Laird |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295328862 PECOS PAC ID: 2365881257 Enrollment ID: I20240411001582 |
| Provider Name | Justin Rothstein |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1770198608 PECOS PAC ID: 3779922554 Enrollment ID: I20240412000732 |
| Provider Name | Kallie Osmundson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518492768 PECOS PAC ID: 7012356801 Enrollment ID: I20240412001317 |
| Provider Name | Claire Alexander |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235887514 PECOS PAC ID: 3375982168 Enrollment ID: I20240412001394 |
| Provider Name | Jennifer Eyers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245625755 PECOS PAC ID: 4082053889 Enrollment ID: I20240412001568 |
| Provider Name | Kimberly Greening |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578095964 PECOS PAC ID: 3678912490 Enrollment ID: I20240412002604 |
| Provider Name | Tao Lee |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1891560322 PECOS PAC ID: 4688013204 Enrollment ID: I20240416001587 |
| Provider Name | Michaela Banz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912611393 PECOS PAC ID: 8224477864 Enrollment ID: I20240416002456 |
| Provider Name | Lauren Paulson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407401045 PECOS PAC ID: 0244679892 Enrollment ID: I20240416002859 |
| Provider Name | Rachael Tarras |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1346497468 PECOS PAC ID: 1951664481 Enrollment ID: I20240416003042 |
| Provider Name | Hallee R Luzinski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649038639 PECOS PAC ID: 7214377530 Enrollment ID: I20240502002787 |
| Provider Name | Melissa Tyo |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1154699791 PECOS PAC ID: 7113367434 Enrollment ID: I20240502002819 |
| Provider Name | Rebecca Magner |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1003451238 PECOS PAC ID: 3072953280 Enrollment ID: I20240503002164 |
| Provider Name | Gary T Olson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790942704 PECOS PAC ID: 0941640122 Enrollment ID: I20240506000335 |
| Provider Name | Whitley Montgomery |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184107682 PECOS PAC ID: 0042651705 Enrollment ID: I20240513000364 |
| Provider Name | David A Scales |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275144032 PECOS PAC ID: 7416362959 Enrollment ID: I20240517002732 |
| Provider Name | Nathan Grumdahl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447989074 PECOS PAC ID: 1951778059 Enrollment ID: I20240522003387 |
| Provider Name | Nicholas M Krause |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1871162693 PECOS PAC ID: 4082075858 Enrollment ID: I20240604000768 |
| Provider Name | Erica E Gress |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295435428 PECOS PAC ID: 1355883422 Enrollment ID: I20240604002330 |
| Provider Name | Kaitlyn Benert |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992377659 PECOS PAC ID: 1759823883 Enrollment ID: I20240605000081 |
| Provider Name | Nadia R Hoffman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821657107 PECOS PAC ID: 2961944012 Enrollment ID: I20240605000808 |
| Provider Name | Dustine A Meyer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699897850 PECOS PAC ID: 7416499298 Enrollment ID: I20240607002150 |
| Provider Name | Meghan Tyler |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1396045183 PECOS PAC ID: 4880136381 Enrollment ID: I20240612002141 |
Metro Care Home Human Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6043 Hudson Rd Ste 340, Woodbury, MN 55125 Phone: 651-528-7141 Fax: 651-528-7897 | |
Prairie Care Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7616 Currell Blvd, Woodbury, MN 55125 Phone: 651-259-9700 Fax: 651-259-9730 | |
Crossroads Counseling Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6053 Hudson Rd Ste 192, Woodbury, MN 55125 Phone: 651-276-8446 | |
Victor Counseling And Consultant Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6043 Hudson Rd Ste 355, Woodbury, MN 55125 Phone: 651-434-9186 | |
Prairie St. John's Clinic Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7616 Currell Blvd, Suite 100, Woodbury, MN 55125 Phone: 651-259-9700 Fax: 651-259-9740 | |
Lori Peiffer, Phd, Lp, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1800 Wooddale Drive, Suite 204, Woodbury, MN 55125 Phone: 612-584-8704 Fax: 844-252-4852 | |
Aris Behavioral Health Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2040 Woodwinds Dr, Woodbury, MN 55125 Phone: 651-259-9750 Fax: 651-259-9790 |