| Kathleen Paige Gullo, | |
|
12805 Highway 55, Suite 211, Plymouth, MN 55441-3859 | |
| (763) 550-9005 | |
| (763) 559-2118 |
| Full Name | Kathleen Paige Gullo |
|---|---|
| Gender | Female |
| Speciality | Counselor - Mental Health |
| Location | 12805 Highway 55, Plymouth, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982776555 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Entity Name | North Central Ministry Development Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164711735 PECOS PAC ID: 7214346345 Enrollment ID: O20210503000006 |
| Mailing Address | Practice Location Address |
|---|---|
| Kathleen Paige Gullo, 12805 Highway 55, Suite 211, Plymouth, MN 55441-3859 Ph: (763) 550-9005 | Kathleen Paige Gullo, 12805 Highway 55, Suite 211, Plymouth, MN 55441-3859 Ph: (763) 550-9005 |
Courtney Hennis, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4100 Berkshire Ln N Ste 250, Plymouth, MN 55446 Phone: 612-223-8898 | |
Jesse Inderlee, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 13895 Industrial Park Blvd, Plymouth, MN 55441 Phone: 763-559-5677 | |
Lauris J Prinsen, L.A.D.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 12805 Highway 55, Suite 211, Plymouth, MN 55441 Phone: 763-550-9005 Fax: 763-559-2118 | |
Jessica Sklar, MA, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 19095 51st Pl N, Plymouth, MN 55446 Phone: 952-212-1330 | |
Hailey Dahl, MA, LPCC Counselor Medicare: Medicare Enrolled Practice Location: 3033 Campus Dr Ste E180, Plymouth, MN 55441 Phone: 952-835-2002 Fax: 651-383-4935 | |
Luke Morken, Counselor Medicare: Not Enrolled in Medicare Practice Location: 10000 Hwy 55 Ste 300, Plymouth, MN 55441 Phone: 763-412-0722 | |
Emily Cross, MA, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 115 Forestview Ln N, Plymouth, MN 55441 Phone: 763-546-8008 |