| St Paul Counseling Services | |
|
1276 University Ave W Saint Paul MN 55104-4101 | |
| (651) 647-3110 | |
| Not Available |
| Full Name | St Paul Counseling Services |
|---|---|
| Speciality | Social Worker |
| Location | 1276 University Ave W, Saint Paul, Minnesota |
| Authorized Official Name and Position | Yolanda O'reilly (BLG MGR) |
| Authorized Official Contact | 6122048387 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St Paul Counseling Services 1200 2nd Ave S Minneapolis MN 55403-2513 Ph: () - | St Paul Counseling Services 1276 University Ave W Saint Paul MN 55104-4101 Ph: (651) 647-3110 |
| NPI Number | 1194828103 |
|---|---|
| Provider Enumeration Date | 09/06/2006 |
| Last Update Date | 01/25/2016 |
| Medicare PECOS PAC ID | 7719988765 |
|---|---|
| Medicare Enrollment ID | O20070118000348 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194828103 | NPI | - | NPPES |
| 265440700 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Timothy A Eiesland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134216344 PECOS PAC ID: 6800897794 Enrollment ID: I20070119000131 |
| Provider Name | Jeffrey David Maciej |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427590355 PECOS PAC ID: 4486930682 Enrollment ID: I20170424000239 |
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