| Birch Lake Counseling Llc | |
|
122 1st St. N. Hackensack MN 56452-0471 | |
| (218) 675-5101 | |
| (801) 340-9860 |
| Full Name | Birch Lake Counseling Llc |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 07/17/2008 |
| Last Update Date | 09/25/2012 |
| Medicare PECOS PAC ID | 5496904971 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598072894 PECOS PAC ID: 0840590337 Enrollment ID: I20151207001006 |
| Provider Name | Carol Ellen Horsager |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1164786398 PECOS PAC ID: 5496904781 Enrollment ID: I20240312002872 |
Essentia Health St. Joseph's-hackensack Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 3rd St. S, Hackensack, MN 56452 Phone: 218-675-5044 Fax: 218-675-5048 |