Richard Carroll Burleson, | |
15265 Carrousel Way, Rosemount, MN 55068-1760 | |
(952) 433-4600 | |
(651) 322-4603 |
Full Name | Richard Carroll Burleson |
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Gender | Male |
Speciality | Counselor - Professional |
Location | 15265 Carrousel Way, Rosemount, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1215504535 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 4845 (Minnesota) | Primary |
Entity Name | Lorenz Clinic Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1982900510 PECOS PAC ID: 7810282845 Enrollment ID: O20160830000081 |
Mailing Address | Practice Location Address |
---|---|
Richard Carroll Burleson, 1772 Stieger Lake Ln, Victoria, MN 55386-7723 Ph: (952) 322-4603 | Richard Carroll Burleson, 15265 Carrousel Way, Rosemount, MN 55068-1760 Ph: (952) 433-4600 |
Kimberly Swanson, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 14325 Cormorant Way, Rosemount, MN 55068 Phone: 612-532-8455 | |
Mr. Brian Paul Ario, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 12802 S Robert Trl, Rosemount, MN 55068 Phone: 952-388-4110 | |
Jennifer Ario, LPCC Counselor Medicare: Medicare Enrolled Practice Location: 12802 S Robert Trl, Rosemount, MN 55068 Phone: 952-388-4850 | |
Kelly J Kivel, LPCC, LPC Counselor Medicare: Medicare Enrolled Practice Location: 15265 Carrousel Way, Rosemount, MN 55068 Phone: 952-443-4600 | |
Mrs. Christina Anne Preston, MA, LADC Counselor Medicare: Medicare Enrolled Practice Location: 15265 Carrousel Way, Rosemount, MN 55068 Phone: 952-443-4600 Fax: 952-443-4604 | |
Alyssa Rose Kittleson, MSW Counselor Medicare: Medicare Enrolled Practice Location: 15265 Carrousel Way, Rosemount, MN 55068 Phone: 952-443-4600 |