| Samuel Secord, | |
|
11990 Portland Ave, Burnsville, MN 55337-1516 | |
| (763) 310-6882 | |
| Not Available |
| Full Name | Samuel Secord |
|---|---|
| Gender | Male |
| Speciality | Marriage & Family Therapist |
| Location | 11990 Portland Ave, Burnsville, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093324022 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 4474 (Minnesota) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (NU) | Secondary |
| Entity Name | Ashlee Secord |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073902177 PECOS PAC ID: 1355719287 Enrollment ID: O20221123002081 |
| Mailing Address | Practice Location Address |
|---|---|
| Samuel Secord, 11990 Portland Ave, Burnsville, MN 55337-1516 Ph: (763) 310-6882 | Samuel Secord, 11990 Portland Ave, Burnsville, MN 55337-1516 Ph: (763) 310-6882 |
David Livingston, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 11986 Portland Ave, Burnsville, MN 55337 Phone: 612-900-3472 |
Nicole Roesler, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 12940 Harriet Ave S Ste 215, Burnsville, MN 55337 Phone: 612-208-8272 |
Wendy Baumler, M.A., LMFT Couples Therapy Medicare: Accepting Medicare Assignments Practice Location: 1500 Mcandrews Rd W, Ste 201, Burnsville, MN 55337 Phone: 952-892-8495 Fax: 651-379-0448 |
Laura Jacqueline Feile, M.A. Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 2970 Judicial Rd, Suite 100, Burnsville, MN 55337 Phone: 952-224-8990 Fax: 952-224-8991 |
Melissa Beth Doucette, MA LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 12751 County Road 5, Suite 101, Burnsville, MN 55337 Phone: 612-242-3171 |
Kathryn M Weise, MA, LMFT Couples Therapy Medicare: Accepting Medicare Assignments Practice Location: 14300 Nicollet Ct Ste 130, Burnsville, MN 55306 Phone: 952-435-8814 Fax: 952-435-7705 |
Mrs. Marissa Mitchell, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 1500 Mcandrews Rd W Ste 227, Burnsville, MN 55337 Phone: 952-892-8402 Fax: 952-892-8402 |