| Carnelia Mental Health Llc | |
|
7300 147th St W Ste 215 Apple Valley MN 55124-7541 | |
| (651) 294-6112 | |
| (651) 294-6715 |
| Full Name | Carnelia Mental Health Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7300 147th St W Ste 215, Apple Valley, Minnesota |
| Authorized Official Name and Position | Elizabeth Kittleson (OWNER) |
| Authorized Official Contact | 6512946112 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carnelia Mental Health Llc 7300 147th St W Ste 215 Apple Valley MN 55124-7541 Ph: (651) 294-6112 | Carnelia Mental Health Llc 7300 147th St W Ste 215 Apple Valley MN 55124-7541 Ph: (651) 294-6112 |
| NPI Number | 1952182172 |
|---|---|
| Provider Enumeration Date | 10/12/2023 |
| Last Update Date | 01/31/2024 |
| Medicare PECOS PAC ID | 5890134803 |
|---|---|
| Medicare Enrollment ID | O20240423002266 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952182172 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Elizabeth Mary Kittleson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1801266366 PECOS PAC ID: 0648619643 Enrollment ID: I20240423002080 |
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