| Speare Psychological Services Pa | |
|
225 1st St N Suite 3100 Virginia MN 55723 | |
| (218) 741-3740 | |
| (218) 741-9492 |
| Full Name | Speare Psychological Services Pa |
|---|---|
| Speciality | Psychologist |
| Location | 225 1st St N, Virginia, Minnesota |
| Authorized Official Name and Position | Jonathan Speare (CEO OWNER) |
| Authorized Official Contact | 2187413740 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Speare Psychological Services Pa 225 1st St N Suite 3100 Virginia MN 55723 Ph: (218) 741-3740 | Speare Psychological Services Pa 225 1st St N Suite 3100 Virginia MN 55723 Ph: (218) 741-3740 |
| NPI Number | 1508086679 |
|---|---|
| Provider Enumeration Date | 04/30/2007 |
| Last Update Date | 08/10/2010 |
| Medicare PECOS PAC ID | 4789752064 |
|---|---|
| Medicare Enrollment ID | O20081014000555 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508086679 | NPI | - | NPPES |
| 074048 | Other | MN | VALUE OPTIONS |
| 100318 | Other | MN | PREFERREDONE |
| 850347800 | Medicaid | MN | |
| 000512001 | Other | MN | MAGELLAN |
| 110500 | Other | MN | UCARE |
| 6101470 | Other | MN | UNITED BEHAVIORAL HEALTH |
| 8L596SP | Other | MN | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | LP0655 (Minnesota) | Primary |
| Provider Name | Jonathan Speare |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962537282 PECOS PAC ID: 1153499405 Enrollment ID: I20081014000328 |
Sonlight Therapeutic Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 505 S 12th Ave, Virginia, MN 55792 Phone: 218-741-5110 Fax: 218-741-5110 | |
Calm Waters Therapy, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 601 S 2nd Ave, Virginia, MN 55792 Phone: 218-404-9611 Fax: 218-414-2600 | |
Quad Cities Therapy Center, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8355 Unity Dr Ste 300, Virginia, MN 55792 Phone: 218-749-3107 Fax: 218-249-0787 | |
Speare & Sampson Pa Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 225 1st St N, Suite 3100, Virginia, MN 55792 Phone: 218-741-3740 | |
The Roses Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 330 3rd St S, Virginia, MN 55792 Phone: 218-639-5510 | |
Range Mental Health Center Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 624 S 13th St, Virginia, MN 55792 Phone: 218-749-2881 Fax: 218-749-3806 |