| Karen Naomi Tyson, MA, LPCC | |
|
1100 Glenwood Ave, Minneapolis, MN 55405-1430 | |
| (612) 871-1454 | |
| Not Available |
| Full Name | Karen Naomi Tyson |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 1100 Glenwood Ave, Minneapolis, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104662964 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 4466 (Minnesota) | Primary |
| Entity Name | Wild Tree Psychotherapy Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528451408 PECOS PAC ID: 8426408881 Enrollment ID: O20231227001431 |
| Mailing Address | Practice Location Address |
|---|---|
| Karen Naomi Tyson, MA, LPCC 906 Vermillion St, Hastings, MN 55033-2135 Ph: (651) 212-4920 | Karen Naomi Tyson, MA, LPCC 1100 Glenwood Ave, Minneapolis, MN 55405-1430 Ph: (612) 871-1454 |
Nelson Perez, Counselor Medicare: Not Enrolled in Medicare Practice Location: 720 E Lake St, Minneapolis, MN 55407 Phone: 612-746-3500 Fax: 612-871-1058 | |
Daniel James Madsen, MA, LPCC Counselor Medicare: Medicare Enrolled Practice Location: 510 1st Ave N Ste 601, Minneapolis, MN 55403 Phone: 612-367-6929 | |
Claire Marie Olson, MA, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 5812 Lyndale Ave S, Minneapolis, MN 55419 Phone: 612-243-4108 Fax: 612-869-0313 | |
Luke Yost, Counselor Medicare: Medicare Enrolled Practice Location: 621 W Lake St, Minneapolis, MN 55408 Phone: 507-530-5507 | |
Mrs. Carmody Alice Sime, LPCC, LADC Counselor Medicare: Medicare Enrolled Practice Location: 701 Park Ave, Minneapolis, MN 55415 Phone: 612-432-2008 | |
Heather Grovum, Counselor Medicare: Not Enrolled in Medicare Practice Location: 310 W 48th St, Minneapolis, MN 55419 Phone: 701-740-4783 | |
Sumaya Yusuf, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3300 5th St Ne Ste 201, Minneapolis, MN 55418 Phone: 651-855-8209 |