| Ron Joseph Zuchora-walske, CLINICALSOCIALWORKER | |
|
5939 Portland Ave South, Minneapolis, MN 55417 | |
| (612) 689-4444 | |
| (612) 254-8244 |
| Full Name | Ron Joseph Zuchora-walske |
|---|---|
| Gender | Male |
| Speciality | Clinical Social Worker |
| Experience | 19 Years |
| Location | 5939 Portland Ave South, Minneapolis, Minnesota |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518140391 | NPI | - | NPPES |
| 642492100 | Medicaid | MN | |
| 24636 | Other | MN | NEW ADDITIONAL LICENSE # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 24636 (Minnesota) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Ellie Family Services Pllp | 8325309669 | 120 |
| Entity Name | Diamond Lake Clinic, P.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740669498 PECOS PAC ID: 8022324664 Enrollment ID: O20150827002511 |
| Entity Name | Ellie Family Services Pllp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740664150 PECOS PAC ID: 8325309669 Enrollment ID: O20180228001972 |
| Mailing Address | Practice Location Address |
|---|---|
| Ron Joseph Zuchora-walske, CLINICALSOCIALWORKER 5733 14th Ave South, Minneapolis, MN 55417-1001 Ph: (612) 719-0965 | Ron Joseph Zuchora-walske, CLINICALSOCIALWORKER 5939 Portland Ave South, Minneapolis, MN 55417 Ph: (612) 689-4444 |
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: Accepting Medicare Assignments 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 |