| Tiny Tree Counseling & Consulting Llc | |
|
3950 Lyndale Ave S Ste 2 Minneapolis MN 55409-1465 | |
| (612) 234-1807 | |
| Not Available |
| Full Name | Tiny Tree Counseling & Consulting Llc |
|---|---|
| Speciality | Counselor |
| Location | 3950 Lyndale Ave S Ste 2, Minneapolis, Minnesota |
| Authorized Official Name and Position | Mary Souder (THERAPIST) |
| Authorized Official Contact | 8334825546 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tiny Tree Counseling & Consulting Llc 3950 Lyndale Ave S Ste 2 Minneapolis MN 55409-1465 Ph: (612) 234-1807 | Tiny Tree Counseling & Consulting Llc 3950 Lyndale Ave S Ste 2 Minneapolis MN 55409-1465 Ph: (612) 234-1807 |
| NPI Number | 1063165355 |
|---|---|
| Provider Enumeration Date | 01/27/2022 |
| Last Update Date | 10/18/2024 |
| Certification Date | 10/18/2024 |
| Medicare PECOS PAC ID | 2365887510 |
|---|---|
| Medicare Enrollment ID | O20240228001369 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063165355 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Mary Meilahn Souder |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831587062 PECOS PAC ID: 3274978424 Enrollment ID: I20240228001681 |
| Provider Name | Kristin Bunge |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992435770 PECOS PAC ID: 5193267656 Enrollment ID: I20240612000723 |
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