| Susan Hoisington Counseling Llc | |
|
1068 Lake St S Ste 102 Forest Lake MN 55025-2633 | |
| (612) 597-3133 | |
| Not Available |
| Full Name | Susan Hoisington Counseling Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1068 Lake St S Ste 102, Forest Lake, Minnesota |
| Authorized Official Name and Position | Susan Hoisington (OWNER) |
| Authorized Official Contact | 6125973133 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan Hoisington Counseling Llc 1324 Bibeau Rd White Bear Lake MN 55110-3600 Ph: (612) 597-3133 | Susan Hoisington Counseling Llc 1068 Lake St S Ste 102 Forest Lake MN 55025-2633 Ph: (612) 597-3133 |
| NPI Number | 1316400740 |
|---|---|
| Provider Enumeration Date | 04/11/2019 |
| Last Update Date | 04/17/2019 |
| Medicare PECOS PAC ID | 1850632977 |
|---|---|
| Medicare Enrollment ID | O20190417002338 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316400740 | NPI | - | NPPES |
| 1104974674 | Other | MN | PSYCHOLOGY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Susan Hoisington |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104974674 PECOS PAC ID: 2163555798 Enrollment ID: I20101101000438 |
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