| The Growlery Llc | |
|
3737 Minnehaha Ave Minneapolis MN 55406 | |
| (612) 605-1410 | |
| (612) 421-0023 |
| Full Name | The Growlery Llc |
|---|---|
| Speciality | Psychologist |
| Location | 3737 Minnehaha Ave, Minneapolis, Minnesota |
| Authorized Official Name and Position | Alexandra Schmidt (OWNER) |
| Authorized Official Contact | 6126051410 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Growlery Llc 3737 Minnehaha Ave Minneapolis MN 55406 Ph: (612) 605-1410 | The Growlery Llc 3737 Minnehaha Ave Minneapolis MN 55406 Ph: (612) 605-1410 |
| NPI Number | 1306412770 |
|---|---|
| Provider Enumeration Date | 05/27/2021 |
| Last Update Date | 03/11/2024 |
| Certification Date | 03/08/2024 |
| Medicare PECOS PAC ID | 1153716055 |
|---|---|
| Medicare Enrollment ID | O20220310002687 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306412770 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
| Provider Name | Alexandra R Schmidt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245782473 PECOS PAC ID: 4284911124 Enrollment ID: I20170503000492 |
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