| Erin Nicole Buller, LICSW | |
|
825 41st Ave Ne, Columbia Heights, MN 55421-2910 | |
| (763) 706-8125 | |
| Not Available |
| Full Name | Erin Nicole Buller |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 825 41st Ave Ne, Columbia Heights, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659090033 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 22171 (Minnesota) | Primary |
| Entity Name | Canvas Health Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922051325 PECOS PAC ID: 8729073978 Enrollment ID: O20040416001178 |
| Mailing Address | Practice Location Address |
|---|---|
| Erin Nicole Buller, LICSW 10077 Dogwood St Nw Ste 200, Coon Rapids, MN 55448-5287 Ph: (651) 443-1923 | Erin Nicole Buller, LICSW 825 41st Ave Ne, Columbia Heights, MN 55421-2910 Ph: (763) 706-8125 |
Soukthanome Thammavong, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 4111 Central Ave Ne Ste 201, Columbia Heights, MN 55421 Phone: 763-283-7194 Fax: 612-437-4535 | |
Maria Hughes, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4301 Tyler St Ne, Columbia Heights, MN 55421 Phone: 651-226-8284 | |
Nabiha Abubakar Ali, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4852 Grandview Ct Ne, Columbia Heights, MN 55421 Phone: 507-573-1039 |