Selah Center For Grief And Loss Llc | |
1001 E 9th St Ste 111 Duluth MN 55805-1604 | |
(218) 590-4199 | |
Not Available |
Full Name | Selah Center For Grief And Loss Llc |
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Speciality | Social Worker |
Location | 1001 E 9th St Ste 111, Duluth, Minnesota |
Authorized Official Name and Position | Debbie Semmelroth (LICSW) |
Authorized Official Contact | 2185904199 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Selah Center For Grief And Loss Llc 1001 E 9th St Ste 111 Duluth MN 55805-1604 Ph: () - | Selah Center For Grief And Loss Llc 1001 E 9th St Ste 111 Duluth MN 55805-1604 Ph: (218) 590-4199 |
NPI Number | 1851008007 |
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Provider Enumeration Date | 10/27/2022 |
Last Update Date | 10/27/2022 |
Certification Date | 10/27/2022 |
Medicare PECOS PAC ID | 1850761305 |
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Medicare Enrollment ID | O20221228001467 |
Identifier | Type | State | Issuer |
---|---|---|---|
1851008007 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Debbie R Semmelroth |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1629677554 PECOS PAC ID: 2961812557 Enrollment ID: I20201111000063 |
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