| Blake Prochnow, | |
|
1380 Walnut St, Prescott, WI 54021-1010 | |
| (612) 382-3458 | |
| Not Available |
| Full Name | Blake Prochnow |
|---|---|
| Gender | Male |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1380 Walnut St, Prescott, Wisconsin |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164093860 | NPI | - | NPPES |
| 540321 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Blake Prochnow, 1900 Silver Lake Rd Nw Ste 110, New Brighton, MN 55112-1789 Ph: (651) 379-1752 | Blake Prochnow, 1380 Walnut St, Prescott, WI 54021-1010 Ph: (612) 382-3458 |
Charles Kaltenberg, Counselor Medicare: Not Enrolled in Medicare Practice Location: N5531 1245th St, Prescott, WI 54021 Phone: 612-584-9071 | |
Diana Devries, Counselor Medicare: Not Enrolled in Medicare Practice Location: N5813 1110th St, Prescott, WI 54021 Phone: 715-441-0072 | |
Caitlin Sparer, MA Counselor Medicare: May Accept Medicare Assignments Practice Location: 371 Monroe St., Prescott, WI 54021 Phone: 507-993-8545 |