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11990 Portland Ave Burnsville MN 55337-1516 | |
| (612) 568-6050 | |
| (952) 736-8375 |
| Full Name | |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 11990 Portland Ave, Burnsville, Minnesota |
| Authorized Official Name and Position | Ashlee Noel Secord (OWNER) |
| Authorized Official Contact | 6125686050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
11990 Portland Ave Burnsville MN 55337-1516 Ph: (612) 568-6050 | 11990 Portland Ave Burnsville MN 55337-1516 Ph: (612) 568-6050 |
| NPI Number | 1073902177 |
|---|---|
| Provider Enumeration Date | 01/13/2015 |
| Last Update Date | 07/15/2022 |
| Certification Date | 07/15/2022 |
| Medicare PECOS PAC ID | 1355719287 |
|---|---|
| Medicare Enrollment ID | O20221123002081 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073902177 | NPI | - | NPPES |
| Provider Name | Ajda Kay Lommen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760724751 PECOS PAC ID: 5294970976 Enrollment ID: I20130329000059 |
| Provider Name | Dawn M Ebeling |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063051639 PECOS PAC ID: 3072949007 Enrollment ID: I20200211001437 |
| Provider Name | Uhunoma Osadolor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295314391 PECOS PAC ID: 3173925823 Enrollment ID: I20210716002533 |
| Provider Name | Matthew Lee Sutera |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265897011 PECOS PAC ID: 2860838422 Enrollment ID: I20240306001973 |
| Provider Name | Ashlee Noel Secord |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1659516888 PECOS PAC ID: 4082082912 Enrollment ID: I20240306002525 |
| Provider Name | Reece Forrester |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1073799102 PECOS PAC ID: 8729452842 Enrollment ID: I20240313001512 |
| Provider Name | Lexie Marie Mccarthy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578240255 PECOS PAC ID: 9032557418 Enrollment ID: I20240404000535 |
| Provider Name | Cindy Lou Fischer-hancock |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1396813671 PECOS PAC ID: 7012355373 Enrollment ID: I20240404004021 |
| Provider Name | Amy Meyer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356931745 PECOS PAC ID: 4981042082 Enrollment ID: I20240409003078 |
| Provider Name | Angela Emily Brodine |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265075162 PECOS PAC ID: 8921446931 Enrollment ID: I20240409003646 |
| Provider Name | Sylke M Knopp |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1528338845 PECOS PAC ID: 0143660548 Enrollment ID: I20240502001435 |
| Provider Name | Andrew Steven Kaehr |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1992098453 PECOS PAC ID: 8628418928 Enrollment ID: I20240503001596 |
| Provider Name | Breanna Reed |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659016541 PECOS PAC ID: 8729527833 Enrollment ID: I20240903001403 |
| Provider Name | Christina Marie Irrgang-wade |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134690969 PECOS PAC ID: 1153861083 Enrollment ID: I20240906001192 |
| Provider Name | Rebecca Jean Hines |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326583626 PECOS PAC ID: 1052844461 Enrollment ID: I20241023004349 |
| Provider Name | Ashley Hauffe |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669803474 PECOS PAC ID: 6507399946 Enrollment ID: I20241024000716 |
Life Interrupted Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1500 Mcandrews Rd W Ste 215, Burnsville, MN 55337 Phone: 952-222-3002 | |
Hrb Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1000 E 146th St Ste 110, Burnsville, MN 55337 Phone: 952-688-9365 | |
The Community Circle, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 14300 Nicollet Ct, Suite 207, Burnsville, MN 55306 Phone: 952-898-7578 Fax: 952-898-7592 |