| Sheepdog Therapy Llc | |
|
1902 5th Ave Ste 4 Anoka MN 55303-2692 | |
| (952) 994-4272 | |
| Not Available |
| Full Name | Sheepdog Therapy Llc |
|---|---|
| Speciality | Counselor |
| Location | 1902 5th Ave Ste 4, Anoka, Minnesota |
| Authorized Official Name and Position | Nicole Zlate (OWNER) |
| Authorized Official Contact | 9529944272 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sheepdog Therapy Llc 1902 5th Ave Ste 4 Anoka MN 55303-2692 Ph: () - | Sheepdog Therapy Llc 1902 5th Ave Ste 4 Anoka MN 55303-2692 Ph: (952) 994-4272 |
| NPI Number | 1831979509 |
|---|---|
| Provider Enumeration Date | 10/02/2023 |
| Last Update Date | 11/09/2023 |
| Certification Date | 11/09/2023 |
| Medicare PECOS PAC ID | 3274974142 |
|---|---|
| Medicare Enrollment ID | O20240509000526 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831979509 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Nicole Zlate |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063014801 PECOS PAC ID: 5092156968 Enrollment ID: I20240509000601 |
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