| Turning Leaf Therapy | |
|
2589 Hamline Ave N Ste C Roseville MN 55113-3185 | |
| (651) 330-6205 | |
| (651) 330-8718 |
| Full Name | Turning Leaf Therapy |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2589 Hamline Ave N Ste C, Roseville, Minnesota |
| Authorized Official Name and Position | Jennifer M Lake (OWNER) |
| Authorized Official Contact | 6513306205 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Turning Leaf Therapy 2589 Hamline Ave N Ste C Roseville MN 55113-3185 Ph: (651) 330-6205 | Turning Leaf Therapy 2589 Hamline Ave N Ste C Roseville MN 55113-3185 Ph: (651) 330-6205 |
| NPI Number | 1124471107 |
|---|---|
| Provider Enumeration Date | 07/14/2016 |
| Last Update Date | 12/14/2021 |
| Certification Date | 12/14/2021 |
| Medicare PECOS PAC ID | 4688002579 |
|---|---|
| Medicare Enrollment ID | O20200306000676 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124471107 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2425 (Minnesota) | Primary |
| Provider Name | Shannon B Pichelman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376907329 PECOS PAC ID: 6507158789 Enrollment ID: I20160708000270 |
| Provider Name | Desiree R Sigecan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679076160 PECOS PAC ID: 3577991462 Enrollment ID: I20200306000716 |
| Provider Name | Nicole Marie Thorsten |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629521950 PECOS PAC ID: 8921499567 Enrollment ID: I20211215002037 |
| Provider Name | Madeleine Louise Calhoon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720619133 PECOS PAC ID: 9032500590 Enrollment ID: I20211217000924 |
| Provider Name | Kristina Braaten |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689664187 PECOS PAC ID: 1951392752 Enrollment ID: I20231221002227 |
| Provider Name | Samantha Hinderks |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093199945 PECOS PAC ID: 9931537826 Enrollment ID: I20231226000407 |
| Provider Name | Suzy Marie Nuetzman |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1184179871 PECOS PAC ID: 5799135992 Enrollment ID: I20240101000154 |
| Provider Name | Jennifer Marie Lake |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1801199302 PECOS PAC ID: 1850729740 Enrollment ID: I20240125000206 |
| Provider Name | Catherine Ann Marin |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1013387489 PECOS PAC ID: 0042663544 Enrollment ID: I20240131004465 |
| Provider Name | Denaya Lou-jean Rockstad |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437798998 PECOS PAC ID: 6901249762 Enrollment ID: I20240208001574 |
| Provider Name | Lindsey Rose Mornson Farmer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548021850 PECOS PAC ID: 7911342936 Enrollment ID: I20240229003111 |
| Provider Name | Laura Martha Hanley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821762899 PECOS PAC ID: 9537505656 Enrollment ID: I20240312002263 |
| Provider Name | Stephanie Jean Kitzhaber |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356903447 PECOS PAC ID: 0749626638 Enrollment ID: I20240314000343 |
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