| James Wiencke, MA, LPCC | |
|
9325 Upland Ln N, Maple Grove, MN 55369-4200 | |
| (612) 924-3807 | |
| Not Available |
| Full Name | James Wiencke |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 9325 Upland Ln N, Maple Grove, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316473960 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | CC02702 (Minnesota) | Primary |
| Entity Name | Family Innovations Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992862783 PECOS PAC ID: 6204178528 Enrollment ID: O20190506002814 |
| Mailing Address | Practice Location Address |
|---|---|
| James Wiencke, MA, LPCC 12167 Robin Rd, Maple Grove, MN 55369-6067 Ph: (952) 562-5758 | James Wiencke, MA, LPCC 9325 Upland Ln N, Maple Grove, MN 55369-4200 Ph: (612) 924-3807 |
Sarah Nicole Olson Venning, LICSW Counselor Medicare: Accepting Medicare Assignments Practice Location: 14500 99th Ave N, Maple Grove, MN 55369 Phone: 651-600-0342 | |
Daniel Knudson, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 13603 80th Cir N, Maple Grove, MN 55369 Phone: 763-274-3120 Fax: 763-274-3121 | |
Blake Malloy, Counselor Medicare: Not Enrolled in Medicare Practice Location: 13603 80th Cir N, Maple Grove, MN 55369 Phone: 763-274-3120 Fax: 763-274-3121 | |
Alysha Kvam, Counselor Medicare: Medicare Enrolled Practice Location: 12918 63rd Ave N, Maple Grove, MN 55369 Phone: 763-210-9966 | |
Barbara Wormington, Counselor Medicare: Not Enrolled in Medicare Practice Location: 10650 County Road 81 Ste N, Maple Grove, MN 55369 Phone: 417-529-3250 | |
Julie Bosacker, Counselor Medicare: Medicare Enrolled Practice Location: 11670 Fountains Dr Ste 200, Maple Grove, MN 55369 Phone: 763-229-7633 | |
Martha Sepulveda, Counselor Medicare: Not Enrolled in Medicare Practice Location: 13603 80th Cir N, Maple Grove, MN 55369 Phone: 763-284-3706 Fax: 763-274-3121 |