| Mr Kyle William Ross, LPCC | |
|
7766 Highway 65 Ne, Spring Lake Park, MN 55432-2832 | |
| (763) 205-4843 | |
| (612) 416-2085 |
| Full Name | Mr Kyle William Ross |
|---|---|
| Gender | Male |
| Speciality | Counselor - Mental Health |
| Location | 7766 Highway 65 Ne, Spring Lake Park, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528502598 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | CC01396 (Minnesota) | Primary |
| Entity Name | Expanse - A Minnesota Mental Health Ketamine & Psychedelic Psychother |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528726775 PECOS PAC ID: 3779940937 Enrollment ID: O20230601002840 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Kyle William Ross, LPCC 7766 Highway 65 Ne, Spring Lake Park, MN 55432-2832 Ph: (763) 205-4843 | Mr Kyle William Ross, LPCC 7766 Highway 65 Ne, Spring Lake Park, MN 55432-2832 Ph: (763) 205-4843 |
Charles Bernard Hilger Jr., LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 7766 Highway 65 Ne, Spring Lake Park, MN 55432 Phone: 612-670-7769 | |
Christina Lefkowich, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 7766 Highway 65 Ne, Spring Lake Park, MN 55432 Phone: 763-298-9100 Fax: 763-298-9250 | |
Kristine Marie Pappone, Counselor Medicare: Not Enrolled in Medicare Practice Location: 7766 Highway 65 Ne, Spring Lake Park, MN 55432 Phone: 763-789-4895 | |
Mr. Aaron Jonathan Close, LPCC, LADC Counselor Medicare: Medicare Enrolled Practice Location: 7766 Highway 65 Ne, Spring Lake Park, MN 55432 Phone: 763-205-4843 | |
Ms. Dawn Hofstad Strommen, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 1485 81st Ave Ne, Spring Lake Park, MN 55432 Phone: 763-780-3036 | |
Magn Nyang, Counselor Medicare: Not Enrolled in Medicare Practice Location: 542 82nd Ave Ne, Spring Lake Park, MN 55432 Phone: 612-636-8926 | |
Mr. Jeffrey Ruhland, MS, LPCC, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 913 Manor Dr Ne, Spring Lake Park, MN 55432 Phone: 612-412-1334 Fax: 612-234-4581 |