| Progressive Individual Resources Inc | |
|
220 Robert St S Ste 206 Saint Paul MN 55107-1692 | |
| (612) 749-3309 | |
| Not Available |
| Full Name | Progressive Individual Resources Inc |
|---|---|
| Speciality | Counselor |
| Location | 220 Robert St S Ste 206, Saint Paul, Minnesota |
| Authorized Official Name and Position | Richard Oni (DIRECTOR) |
| Authorized Official Contact | 6127493309 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Progressive Individual Resources Inc 2147 University Ave W Ste 206 Saint Paul MN 55114-1327 Ph: () - | Progressive Individual Resources Inc 220 Robert St S Ste 206 Saint Paul MN 55107-1692 Ph: (612) 749-3309 |
| NPI Number | 1326620352 |
|---|---|
| Provider Enumeration Date | 04/28/2021 |
| Last Update Date | 04/28/2021 |
| Certification Date | 04/28/2021 |
| Medicare PECOS PAC ID | 3375908445 |
|---|---|
| Medicare Enrollment ID | O20230424002623 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326620352 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| Provider Name | Ashley Hanson-oni |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124654751 PECOS PAC ID: 4284099359 Enrollment ID: I20230424002705 |
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