| Brandon Stavish, | |
|
1321 13th St N, Saint Cloud, MN 56303-2613 | |
| (320) 202-2060 | |
| Not Available |
| Full Name | Brandon Stavish |
|---|---|
| Gender | Male |
| Speciality | Counselor - Mental Health |
| Location | 1321 13th St N, Saint Cloud, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508412925 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | CC02196 (Minnesota) | Primary |
| Entity Name | Central Minnesota Mental Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831177195 PECOS PAC ID: 4486555877 Enrollment ID: O20040119000248 |
| Mailing Address | Practice Location Address |
|---|---|
| Brandon Stavish, 1321 13th St N, Saint Cloud, MN 56303-2613 Ph: (320) 202-2060 | Brandon Stavish, 1321 13th St N, Saint Cloud, MN 56303-2613 Ph: (320) 202-2060 |
Emmanuel Oppong, Counselor Medicare: Medicare Enrolled Practice Location: 22 Wilson Ave Ne Ste 209, Saint Cloud, MN 56304 Phone: 320-237-6996 | |
Billy M Anderson, LICSW LADC Counselor Medicare: Medicare Enrolled Practice Location: 22 Wilson Ave Ne, 209, Saint Cloud, MN 56304 Phone: 320-259-7706 Fax: 320-251-4590 | |
Victoria Richter, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4801 Veterans Dr, Saint Cloud, MN 56303 Phone: 320-252-1670 | |
Mallorie Hesse, MS, LPCC, LADC Counselor Medicare: Medicare Enrolled Practice Location: 1321 13th St N Bldg A, Saint Cloud, MN 56303 Phone: 320-252-5010 | |
Benedict A Walz, MS MDV MAC LADC LMFT Counselor Medicare: Not Enrolled in Medicare Practice Location: 3333 W Division St, Midtown Square Suite # 210, Saint Cloud, MN 56301 Phone: 320-252-5781 Fax: 320-252-5001 | |
Tonya Sharon Klug, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1321 13th St N, Saint Cloud, MN 56303 Phone: 320-252-5010 Fax: 320-203-1855 | |
Hamdi Mahat Sirat, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2719 W Division St Ste 5, Saint Cloud, MN 56301 Phone: 952-212-0358 |