| The Therapist Plc | |
|
401 W Laurel St Ste C Brainerd MN 56401-3970 | |
| (218) 454-3288 | |
| (218) 461-3873 |
| Full Name | The Therapist Plc |
|---|---|
| Speciality | Counselor |
| Location | 401 W Laurel St Ste C, Brainerd, Minnesota |
| Authorized Official Name and Position | Claribel Severson (OWNER/THERAPIST) |
| Authorized Official Contact | 2184543288 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Therapist Plc 401 W Laurel St Ste C Brainerd MN 56401-3970 Ph: (218) 454-3288 | The Therapist Plc 401 W Laurel St Ste C Brainerd MN 56401-3970 Ph: (218) 454-3288 |
| NPI Number | 1093263113 |
|---|---|
| Provider Enumeration Date | 09/19/2016 |
| Last Update Date | 03/03/2021 |
| Certification Date | 02/16/2021 |
| Medicare PECOS PAC ID | 7618383951 |
|---|---|
| Medicare Enrollment ID | O20210310002167 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093263113 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 1304 (Minnesota) | Primary |
| Provider Name | Kimberly Dwinnell-dillon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497112254 PECOS PAC ID: 9335445279 Enrollment ID: I20160302002620 |
| Provider Name | Jamie Whiteman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194105205 PECOS PAC ID: 5395090435 Enrollment ID: I20180614000050 |
| Provider Name | Teresia Ann Mortenson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811775968 PECOS PAC ID: 0749625945 Enrollment ID: I20240227004132 |
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