| West End Therapy Clinic Llc | |
|
6465 Wayzata Blvd Ste 710 St Louis Park MN 55426-1733 | |
| (651) 353-5007 | |
| Not Available |
| Full Name | West End Therapy Clinic Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 6465 Wayzata Blvd Ste 710, St Louis Park, Minnesota |
| Authorized Official Name and Position | Terry Lynn Norman (OWNER) |
| Authorized Official Contact | 6513535007 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| West End Therapy Clinic Llc 6465 Wayzata Blvd Ste 710 St Louis Park MN 55426-1733 Ph: (651) 353-5007 | West End Therapy Clinic Llc 6465 Wayzata Blvd Ste 710 St Louis Park MN 55426-1733 Ph: (651) 353-5007 |
| NPI Number | 1407332547 |
|---|---|
| Provider Enumeration Date | 07/12/2018 |
| Last Update Date | 02/07/2024 |
| Certification Date | 02/07/2024 |
| Medicare PECOS PAC ID | 7113361916 |
|---|---|
| Medicare Enrollment ID | O20240220004094 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407332547 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Shlomo Y Schloss |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821413816 PECOS PAC ID: 5698058584 Enrollment ID: I20180117000872 |
| Provider Name | Terry Lynn Norman |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1174863435 PECOS PAC ID: 2466896261 Enrollment ID: I20240220004219 |
| Provider Name | Lisa Watson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1407304314 PECOS PAC ID: 2668817008 Enrollment ID: I20240226001878 |
| Provider Name | Jeffery Allen Nelson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1043914393 PECOS PAC ID: 9638514912 Enrollment ID: I20240226003646 |
| Provider Name | Breana Foley |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1104490242 PECOS PAC ID: 8224477146 Enrollment ID: I20240411002743 |
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