| Soukthanome Thammavong, LICSW | |
|
4111 Central Ave Ne Ste 201, Columbia Heights, MN 55421-2960 | |
| (763) 283-7194 | |
| (612) 437-4535 |
| Full Name | Soukthanome Thammavong |
|---|---|
| Gender | Female |
| Speciality | Clinical Social Worker |
| Experience | 18 Years |
| Location | 4111 Central Ave Ne Ste 201, Columbia Heights, Minnesota |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164986246 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Entity Name | Regents Of The University Of Minnesota |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114019858 PECOS PAC ID: 7416856059 Enrollment ID: O20040102000679 |
| Entity Name | Anoka Health Center Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053816389 PECOS PAC ID: 7719307735 Enrollment ID: O20201013002528 |
| Mailing Address | Practice Location Address |
|---|---|
| Soukthanome Thammavong, LICSW 2001 Bloomington Ave, Minneapolis, MN 55404-3074 Ph: (612) 249-0941 | Soukthanome Thammavong, LICSW 4111 Central Ave Ne Ste 201, Columbia Heights, MN 55421-2960 Ph: (763) 283-7194 |
Maria Hughes, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4301 Tyler St Ne, Columbia Heights, MN 55421 Phone: 651-226-8284 | |
Erin Nicole Buller, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 825 41st Ave Ne, Columbia Heights, MN 55421 Phone: 763-706-8125 | |
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 |