| Therapeutic Services Agency Inc | |
|
220 Railroad St Se Pine City MN 55063-1540 | |
| (320) 629-7600 | |
| (651) 925-0071 |
| Full Name | Therapeutic Services Agency Inc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 220 Railroad St Se, Pine City, Minnesota |
| Authorized Official Name and Position | Stephanie Purdy (ASSISTANT BUSINESS DIRECTOR) |
| Authorized Official Contact | 3206297600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapeutic Services Agency Inc 220 Railroad St Se Pine City MN 55063-1540 Ph: (320) 629-7600 | Therapeutic Services Agency Inc 220 Railroad St Se Pine City MN 55063-1540 Ph: (320) 629-7600 |
| NPI Number | 1497741607 |
|---|---|
| Provider Enumeration Date | 09/22/2005 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 4981877891 |
|---|---|
| Medicare Enrollment ID | O20111109000030 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497741607 | NPI | - | NPPES |
| 757519000 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (Minnesota) | Secondary |
| 104100000X | Social Worker | (Minnesota) | Secondary |
| 106H00000X | Marriage & Family Therapist | (Minnesota) | Primary |
| Provider Name | Christine T Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033259411 PECOS PAC ID: 5193813954 Enrollment ID: I20071113000437 |
| Provider Name | Annette V Huff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871812735 PECOS PAC ID: 0042229122 Enrollment ID: I20111111000209 |
| Provider Name | Don L Moyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922404672 PECOS PAC ID: 2567784507 Enrollment ID: I20141203000290 |
| Provider Name | Miranda Jean Gilmore |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114148798 PECOS PAC ID: 3476863895 Enrollment ID: I20151113001442 |
| Provider Name | Lainie Kristen Janke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740275395 PECOS PAC ID: 4981990694 Enrollment ID: I20160907000478 |
| Provider Name | Angela Marie Kemen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114571734 PECOS PAC ID: 2466781323 Enrollment ID: I20190903001568 |
| Provider Name | Mary Alice Rose Mchugh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093006827 PECOS PAC ID: 4486085040 Enrollment ID: I20200514001821 |
| Provider Name | David Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548972425 PECOS PAC ID: 4385001361 Enrollment ID: I20230606003501 |
| Provider Name | Jonathan David Pieper |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1619353844 PECOS PAC ID: 6103278825 Enrollment ID: I20240118002194 |
| Provider Name | Julianne L. Carlson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750680054 PECOS PAC ID: 1557714664 Enrollment ID: I20240125000189 |
| Provider Name | James T Molberg |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649265281 PECOS PAC ID: 1355794124 Enrollment ID: I20240129000432 |
| Provider Name | John William Eskola |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1467474197 PECOS PAC ID: 6103269725 Enrollment ID: I20240209002876 |
| Provider Name | Lori Vigesaa |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841823002 PECOS PAC ID: 0840634200 Enrollment ID: I20240214001094 |
| Provider Name | Cara L. Howard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073890448 PECOS PAC ID: 0446694707 Enrollment ID: I20240215000651 |
| Provider Name | Sarah L Busch |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245405539 PECOS PAC ID: 5597109702 Enrollment ID: I20240215002718 |
| Provider Name | Anna Noel Rydberg |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306609201 PECOS PAC ID: 7618311622 Enrollment ID: I20240219000488 |
| Provider Name | Nichole Suzzanne Melby |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1952773285 PECOS PAC ID: 9638516370 Enrollment ID: I20240318001992 |
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Therapeutic Services Agency Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 220 Railroad St Se, Pine City, MN 55063 Phone: 320-629-7600 Fax: 320-629-7900 |