Birch Lake Counseling Llc | |
122 1st St. N. Hackensack MN 56452-0471 | |
(218) 675-5101 | |
(801) 340-9860 |
Full Name | Birch Lake Counseling Llc |
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Speciality | Clinic/Center |
Location | 122 1st St. N., Hackensack, Minnesota |
Authorized Official Name and Position | Carol E. Horsager (OWNER) |
Authorized Official Contact | 2186755101 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Birch Lake Counseling Llc Po Box 471 Hackensack MN 56452-0471 Ph: (218) 675-5101 | Birch Lake Counseling Llc 122 1st St. N. Hackensack MN 56452-0471 Ph: (218) 675-5101 |
NPI Number | 1760646715 |
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Provider Enumeration Date | 07/17/2008 |
Last Update Date | 09/25/2012 |
Medicare PECOS PAC ID | 5496904971 |
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Medicare Enrollment ID | O20120926000579 |
Identifier | Type | State | Issuer |
---|---|---|---|
1760646715 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Shannon Kempf |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1598072894 PECOS PAC ID: 0840590337 Enrollment ID: I20151207001006 |
Provider Name | Carol Ellen Horsager |
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Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1164786398 PECOS PAC ID: 5496904781 Enrollment ID: I20240312002872 |
Provider Name | Violet Irene Sundermeyer |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1285877142 PECOS PAC ID: 0648719476 Enrollment ID: I20240826000642 |
Provider Name | Kate Jodell Beaman Friesner |
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Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1073997128 PECOS PAC ID: 2466986567 Enrollment ID: I20241112003466 |