| |
7242 Forestview Ln N The Counseling Shop Maple Grove MN 55369-5628 | |
(763) 400-7075 | |
(763) 400-7078 |
Full Name | |
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Speciality | Social Worker |
Location | 7242 Forestview Ln N, Maple Grove, Minnesota |
Authorized Official Name and Position | Patricia Ann Hill (OWNER) |
Authorized Official Contact | 7632294933 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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7242 Forestview Ln N The Counseling Shop Maple Grove MN 55369-5628 Ph: (763) 400-7075 | 7242 Forestview Ln N The Counseling Shop Maple Grove MN 55369-5628 Ph: (763) 400-7075 |
NPI Number | 1588954176 |
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Provider Enumeration Date | 04/15/2011 |
Last Update Date | 11/01/2011 |
Medicare PECOS PAC ID | 7416121322 |
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Medicare Enrollment ID | O20111110000461 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588954176 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 15021 (Minnesota) | Primary |
Provider Name | Patricia A Hill |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1881657229 PECOS PAC ID: 6507894391 Enrollment ID: I20050802000977 |
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