Success Psychological Services Pllc | |
2239 Carter Ave # 202 Saint Paul MN 55108-1638 | |
(612) 965-6135 | |
(651) 645-2439 |
Full Name | Success Psychological Services Pllc |
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Speciality | Clinic/Center |
Location | 2239 Carter Ave # 202, Saint Paul, Minnesota |
Authorized Official Name and Position | Glenn Phillip Hirsch (CEO) |
Authorized Official Contact | 6129656135 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Success Psychological Services Pllc 2239 Carter Ave # 202 Saint Paul MN 55108-1638 Ph: (612) 965-6135 | Success Psychological Services Pllc 2239 Carter Ave # 202 Saint Paul MN 55108-1638 Ph: (612) 965-6135 |
NPI Number | 1184189714 |
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Provider Enumeration Date | 02/07/2019 |
Last Update Date | 02/07/2019 |
Medicare PECOS PAC ID | 9234565425 |
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Medicare Enrollment ID | O20240919000653 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184189714 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
Provider Name | Glenn Phillip Hirsch |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1437207115 PECOS PAC ID: 8224464417 Enrollment ID: I20240919000902 |
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