Carrie Weller, LPCC/LADC | |
2103 County Road D E Ste A, Maplewood, MN 55109-5357 | |
(651) 401-8858 | |
Not Available |
Full Name | Carrie Weller |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 2103 County Road D E Ste A, Maplewood, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1053973339 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | 304302 (Minnesota) | Secondary |
101YP2500X | Counselor - Professional | CC01795 (Minnesota) | Primary |
Entity Name | Ellie Family Services Pllp |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1740664150 PECOS PAC ID: 8325309669 Enrollment ID: O20180228001972 |
Mailing Address | Practice Location Address |
---|---|
Carrie Weller, LPCC/LADC 945 17th St, Newport, MN 55055-1609 Ph: (651) 468-4350 | Carrie Weller, LPCC/LADC 2103 County Road D E Ste A, Maplewood, MN 55109-5357 Ph: (651) 401-8858 |
Mr. Andrew A Johnson, BA BS MSW LICSW LADC Counselor Medicare: May Accept Medicare Assignments Practice Location: 981 Glendon St N, Maplewood, MN 55119 Phone: 612-354-9027 | |
Mark Charles Lightner, B.A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 2115 County Road D E # B, Maplewood, MN 55109 Phone: 651-748-5019 Fax: 651-773-7591 | |
Cynthia Burgess, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2103 County Road D E Ste B, Maplewood, MN 55109 Phone: 651-748-5019 | |
Khong Kaleb Mua, M.A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 2115 County Road D E # B, Maplewood, MN 55109 Phone: 651-748-5019 Fax: 651-773-7591 | |
Kiley Christine Krocak, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2115 County Road D E, Suite B, Maplewood, MN 55109 Phone: 651-748-5019 Fax: 651-773-7591 | |
Joel Lambrides, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2103 County Road D E Ste B, Maplewood, MN 55109 Phone: 651-748-5019 |