| Up North Therapy | |
|
12 Lee Cir Silver Bay MN 55614-1107 | |
| (218) 220-9699 | |
| Not Available |
| Full Name | Up North Therapy |
|---|---|
| Speciality | Clinic/Center |
| Location | 12 Lee Cir, Silver Bay, Minnesota |
| Authorized Official Name and Position | Ashley L Belanger (OWNER) |
| Authorized Official Contact | 2182209699 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Up North Therapy 12 Lee Cir Silver Bay MN 55614-1107 Ph: (218) 220-9699 | Up North Therapy 12 Lee Cir Silver Bay MN 55614-1107 Ph: (218) 220-9699 |
| NPI Number | 1154918951 |
|---|---|
| Provider Enumeration Date | 12/28/2020 |
| Last Update Date | 12/28/2020 |
| Certification Date | 12/28/2020 |
| Medicare PECOS PAC ID | 3577928969 |
|---|---|
| Medicare Enrollment ID | O20230509001208 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154918951 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Andrea Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427441104 PECOS PAC ID: 3476870296 Enrollment ID: I20171214002164 |
| Provider Name | Debbie Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215331178 PECOS PAC ID: 4880028216 Enrollment ID: I20231030003456 |
| Provider Name | Ashley L Belanger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346738952 PECOS PAC ID: 9830554229 Enrollment ID: I20241028003109 |
| Provider Name | Lydia Walker-thoennes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336639137 PECOS PAC ID: 0941734891 Enrollment ID: I20241114001806 |