| Thestral Therapy, Llc | |
|
7421 Parkview Dr Saint Paul MN 55112-4118 | |
| (651) 500-1377 | |
| Not Available |
| Full Name | Thestral Therapy, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7421 Parkview Dr, Saint Paul, Minnesota |
| Authorized Official Name and Position | Brittney Rademacher (OWNER/MENTAL HEALTH THERAPIST) |
| Authorized Official Contact | 6515001377 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thestral Therapy, Llc 7421 Parkview Dr Saint Paul MN 55112-4118 Ph: (651) 500-1377 | Thestral Therapy, Llc 7421 Parkview Dr Saint Paul MN 55112-4118 Ph: (651) 500-1377 |
| NPI Number | 1154091502 |
|---|---|
| Provider Enumeration Date | 09/16/2021 |
| Last Update Date | 09/16/2021 |
| Certification Date | 09/16/2021 |
| Medicare PECOS PAC ID | 7416349071 |
|---|---|
| Medicare Enrollment ID | O20220112000697 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154091502 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Brittney L Rademacher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932780996 PECOS PAC ID: 7315343779 Enrollment ID: I20210909002888 |
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