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1102 E 4th St Duluth MN 55805-2219 | |
| (218) 310-8896 | |
| (218) 206-6276 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 1102 E 4th St, Duluth, Minnesota |
| Authorized Official Name and Position | Lindsay L Merritt (ADMINISTRATIVE COORDINATOR) |
| Authorized Official Contact | 2182069390 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1001 Avenue B Cloquet MN 55720-1631 Ph: (218) 310-8896 | 1102 E 4th St Duluth MN 55805-2219 Ph: (218) 310-8896 |
| NPI Number | 1073021036 |
|---|---|
| Provider Enumeration Date | 01/11/2018 |
| Last Update Date | 11/26/2024 |
| Certification Date | 11/26/2024 |
| Medicare PECOS PAC ID | 2163767286 |
|---|---|
| Medicare Enrollment ID | O20181218003025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073021036 | NPI | - | NPPES |
| 1386005601 | Medicaid | MN |
| Provider Name | Chad E Fey |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588699359 PECOS PAC ID: 5092706499 Enrollment ID: I20040524000761 |
| Provider Name | Kathy Busick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093190159 PECOS PAC ID: 1153637350 Enrollment ID: I20150902003052 |
| Provider Name | Timothy R Weber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386005601 PECOS PAC ID: 6406154434 Enrollment ID: I20160407001439 |
| Provider Name | Jeremy D Perrett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144670571 PECOS PAC ID: 4789917154 Enrollment ID: I20190618000839 |
| Provider Name | Karissa Ann Haugen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275124463 PECOS PAC ID: 9133528508 Enrollment ID: I20210604001985 |
| Provider Name | Jill C Bloomer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073135869 PECOS PAC ID: 3678970985 Enrollment ID: I20210928003396 |
| Provider Name | Tracy Kwapick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275298432 PECOS PAC ID: 6406220441 Enrollment ID: I20230315000144 |
| Provider Name | Anne Katherine Hendricks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235850991 PECOS PAC ID: 7810362670 Enrollment ID: I20230407001548 |
| Provider Name | Danie-marie Osterlund |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1972740025 PECOS PAC ID: 5092171959 Enrollment ID: I20240408001004 |
| Provider Name | Breanna Marie Mae Hatinen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548834922 PECOS PAC ID: 6305284209 Enrollment ID: I20240410001991 |
| Provider Name | Kali Elisabeth Carlson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992202972 PECOS PAC ID: 3779922661 Enrollment ID: I20240411001451 |
| Provider Name | Rachel Lynn Frost |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093559908 PECOS PAC ID: 1254865439 Enrollment ID: I20241127002578 |
Living Hope Counseling & Coaching, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 230 W Superior St, Suite 400, Duluth, MN 55802 Phone: 218-341-9158 Fax: 218-626-1464 | |
Matheny Therapy & Consulting Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 4328 E Superior St, Duluth, MN 55804 Phone: 715-296-9429 | |
Zenith City Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1132 E 3rd St, Duluth, MN 55805 Phone: 773-573-7783 | |
True North Psychiatry Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7302 Clay St, Duluth, MN 55810 Phone: 218-384-1714 | |
Krystle Haugen, Lmft, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 W 2nd St Ste 150d, Duluth, MN 55802 Phone: 218-480-0145 |