| Jessica Luehring, | |
|
7766 Highway 65 Ne, Spring Lake Park, MN 55432-2832 | |
| (763) 205-4843 | |
| (612) 416-2085 |
| Full Name | Jessica Luehring |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 7766 Highway 65 Ne, Spring Lake Park, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639543556 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 20560 (Minnesota) | Primary |
| Entity Name | Expanse - A Minnesota Mental Health Ketamine & Psychedelic Psychother |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528726775 PECOS PAC ID: 3779940937 Enrollment ID: O20230601002840 |
| Mailing Address | Practice Location Address |
|---|---|
| Jessica Luehring, 7766 Highway 65 Ne, Spring Lake Park, MN 55432-2832 Ph: (763) 205-4843 | Jessica Luehring, 7766 Highway 65 Ne, Spring Lake Park, MN 55432-2832 Ph: (763) 205-4843 |
John Dwight Ferguson, LICSW Clinical Social Worker Medicare: May Accept Medicare Assignments Practice Location: 1340 81st Ave Ne, Spring Lake Park, MN 55432 Phone: 763-783-4528 Fax: 763-786-9729 | |
Jessica Mae Grantman, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 7766 Highway 65 Ne, Spring Lake Park, MN 55432 Phone: 763-205-4843 Fax: 612-416-2085 |