| Canopy Mental Health & Consulting | |
|
6625 Lyndale Ave S Ste 440 Richfield MN 55423-2380 | |
| (612) 712-7200 | |
| Not Available |
| Full Name | Canopy Mental Health & Consulting |
|---|---|
| Speciality | Counselor |
| Location | 6625 Lyndale Ave S Ste 440, Richfield, Minnesota |
| Authorized Official Name and Position | Candace Hanson (PSYCHOTHERAPIST) |
| Authorized Official Contact | 6127127200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Canopy Mental Health & Consulting 6625 Lyndale Ave S Ste 440 Richfield MN 55423-2380 Ph: (612) 712-7200 | Canopy Mental Health & Consulting 6625 Lyndale Ave S Ste 440 Richfield MN 55423-2380 Ph: (612) 712-7200 |
| NPI Number | 1780221887 |
|---|---|
| Provider Enumeration Date | 12/08/2019 |
| Last Update Date | 10/26/2021 |
| Certification Date | 10/26/2021 |
| Medicare PECOS PAC ID | 1850795113 |
|---|---|
| Medicare Enrollment ID | O20211220001690 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780221887 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Nancy J Avila |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982055778 PECOS PAC ID: 2769776848 Enrollment ID: I20160812000062 |
| Provider Name | Crystal J Hopkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124214663 PECOS PAC ID: 5890847081 Enrollment ID: I20190205001452 |
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