| Shire Counseling Llc | |
|
11468 Marketplace Dr N Ste 600-324 Champlin MN 55316-3872 | |
| (763) 260-5730 | |
| Not Available |
| Full Name | Shire Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 11468 Marketplace Dr N Ste 600-324, Champlin, Minnesota |
| Authorized Official Name and Position | Jessica Ladner (OWNER/MENTAL HEALTH PROFESSIONAL) |
| Authorized Official Contact | 7632605730 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shire Counseling Llc 11468 Marketplace Dr N Ste 600-324 Champlin MN 55316-3872 Ph: (763) 260-5730 | Shire Counseling Llc 11468 Marketplace Dr N Ste 600-324 Champlin MN 55316-3872 Ph: (763) 260-5730 |
| NPI Number | 1770266934 |
|---|---|
| Provider Enumeration Date | 08/14/2023 |
| Last Update Date | 08/14/2023 |
| Certification Date | 08/13/2023 |
| Medicare PECOS PAC ID | 5496108193 |
|---|---|
| Medicare Enrollment ID | O20240130000745 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770266934 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jessica Ladner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457941387 PECOS PAC ID: 3072915800 Enrollment ID: I20210715001958 |
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