| Tena Lorayn Prestidge, | |
|
3220 4th St E Ste 102, West Fargo, ND 58078-3082 | |
| (701) 501-7449 | |
| (701) 425-0322 |
| Full Name | Tena Lorayn Prestidge |
|---|---|
| Gender | Female |
| Speciality | Counselor - Mental Health |
| Location | 3220 4th St E Ste 102, West Fargo, North Dakota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427787936 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Entity Name | Canopy Medical Clinic, Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386280261 PECOS PAC ID: 3678900016 Enrollment ID: O20200225002372 |
| Mailing Address | Practice Location Address |
|---|---|
| Tena Lorayn Prestidge, 3220 4th St E Ste 102, West Fargo, ND 58078-3082 Ph: (701) 501-7449 | Tena Lorayn Prestidge, 3220 4th St E Ste 102, West Fargo, ND 58078-3082 Ph: (701) 501-7449 |
Andrea Joy Klobuchar, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 102 W Beaton Dr Ste 103, West Fargo, ND 58078 Phone: 701-730-8313 Fax: 701-552-7975 | |
Valerie Austin, LAPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 875 34th Ave E Apt 103, West Fargo, ND 58078 Phone: 701-491-8260 | |
Ms. Erin R Hagen, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3239 Oak Ridge Loop E, West Fargo, ND 58078 Phone: 701-478-7199 Fax: 701-478-1763 | |
Amber Bach-gorman, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3227 Oak Ridge Loop E, West Fargo, ND 58078 Phone: 701-419-8702 Fax: 701-520-8457 | |
Emily A. Althoff, L.A.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 509 Oak Ridge Way E, West Fargo, ND 58078 Phone: 701-318-4321 | |
Presley Morstad, Counselor Medicare: Medicare Enrolled Practice Location: 1520 2nd Ave Nw, West Fargo, ND 58078 Phone: 701-412-2973 |