|
| |
|
615 8th Ave Ne Pine City MN 55063-1172 | |
| (651) 347-8499 | |
| (651) 390-6333 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 615 8th Ave Ne, Pine City, Minnesota |
| Authorized Official Name and Position | Mari Soma-ringness (OWNER) |
| Authorized Official Contact | 6513478499 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
615 8th Ave Ne Pine City MN 55063-1172 Ph: (651) 347-8499 | 615 8th Ave Ne Pine City MN 55063-1172 Ph: (651) 347-8499 |
| NPI Number | 1245966803 |
|---|---|
| Provider Enumeration Date | 07/26/2022 |
| Last Update Date | 12/27/2023 |
| Certification Date | 12/27/2023 |
| Medicare PECOS PAC ID | 7517403553 |
|---|---|
| Medicare Enrollment ID | O20240725003031 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245966803 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Mari Margaret Soma-ringness |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356919211 PECOS PAC ID: 8426594466 Enrollment ID: I20240725003193 |
Avalon - Pine City Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 655 3rd Ave Sw, Pine City, MN 55063 Phone: 612-326-7555 | |
Empower Recovery Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 509 3rd Ave Se, Pine City, MN 55063 Phone: 320-629-0059 Fax: 320-629-9983 | |
Therapeutic Services Agency Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 220 Railroad St Se, Pine City, MN 55063 Phone: 320-629-7600 Fax: 651-925-0071 | |
Rise Up Psychological Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1100 Holstein Dr Ne, Pine City, MN 55063 Phone: 320-322-5122 Fax: 844-990-4122 | |
Therapeutic Services Agency Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 220 Railroad St Se, Pine City, MN 55063 Phone: 320-629-7600 Fax: 320-629-7900 |