| Family Support Services Inc. | |
|
1900 Silver Lake Rd Nw Suite 115 New Brighton MN 55112-1786 | |
| (651) 628-4993 | |
| (651) 379-1772 |
| Full Name | Family Support Services Inc. |
|---|---|
| Speciality | Counselor |
| Location | 1900 Silver Lake Rd Nw, New Brighton, Minnesota |
| Authorized Official Name and Position | Ann Eiden (VP OF OPERATIONS) |
| Authorized Official Contact | 6513791750 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Support Services Inc. 1900 Silver Lake Rd Nw Suite 115 New Brighton MN 55112-1786 Ph: (651) 628-4993 | Family Support Services Inc. 1900 Silver Lake Rd Nw Suite 115 New Brighton MN 55112-1786 Ph: (651) 628-4993 |
| NPI Number | 1467549220 |
|---|---|
| Provider Enumeration Date | 10/05/2006 |
| Last Update Date | 03/02/2016 |
| Medicare PECOS PAC ID | 0244297448 |
|---|---|
| Medicare Enrollment ID | O20041220000008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467549220 | NPI | - | NPPES |
| 520038500 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Brian A Nystrom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326075813 PECOS PAC ID: 8729984737 Enrollment ID: I20071010000263 |
| Provider Name | Colette Rose Neron Ellenbecker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912267287 PECOS PAC ID: 7911153184 Enrollment ID: I20120804000065 |
| Provider Name | Arielah Miriam King |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225392764 PECOS PAC ID: 1557517729 Enrollment ID: I20120804000068 |
| Provider Name | Lindsey A Werner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417217837 PECOS PAC ID: 7416108857 Enrollment ID: I20121113000465 |
| Provider Name | Amber Schneider |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184036329 PECOS PAC ID: 4284858564 Enrollment ID: I20140605001969 |
| Provider Name | Julie M Christensen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407258387 PECOS PAC ID: 5395061311 Enrollment ID: I20150310000027 |
| Provider Name | Jennifer L Czischke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255795969 PECOS PAC ID: 0941509541 Enrollment ID: I20160503002400 |
| Provider Name | Angela Khalar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831549260 PECOS PAC ID: 3779875356 Enrollment ID: I20160630001772 |
| Provider Name | Neil A Greco |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497084339 PECOS PAC ID: 0446531131 Enrollment ID: I20170112000760 |
| Provider Name | Britne E Haasch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548771975 PECOS PAC ID: 1153689195 Enrollment ID: I20171220000506 |
| Provider Name | Sarah G Hanson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093213704 PECOS PAC ID: 6709147044 Enrollment ID: I20180228001921 |
| Provider Name | Kaila M Farnsworth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700479268 PECOS PAC ID: 2567840168 Enrollment ID: I20220610001316 |
| Provider Name | Maureen Elizabeth Murray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063119188 PECOS PAC ID: 6800256504 Enrollment ID: I20230712004728 |
| Provider Name | Paige Welle |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376934547 PECOS PAC ID: 6608226469 Enrollment ID: I20231220002273 |
| Provider Name | Seraphine Zoe Esta Violet Aker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356794465 PECOS PAC ID: 2769832526 Enrollment ID: I20231220002343 |
| Provider Name | Nicole E Kirkpatrick |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1104398577 PECOS PAC ID: 5092168724 Enrollment ID: I20240130001929 |
| Provider Name | Robert Wayne Eddy |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1063146538 PECOS PAC ID: 3375996754 Enrollment ID: I20240201002468 |
| Provider Name | Rie Anderson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730531237 PECOS PAC ID: 5698110807 Enrollment ID: I20240228000109 |
| Provider Name | Christina J Fike |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053823955 PECOS PAC ID: 1557706793 Enrollment ID: I20240228000968 |
| Provider Name | Dana Marie Seelen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205324647 PECOS PAC ID: 1254777089 Enrollment ID: I20240314002246 |
| Provider Name | Holly Laluzerne |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699202382 PECOS PAC ID: 4981040607 Enrollment ID: I20240315001618 |
| Provider Name | Philip Caleb Zastrow |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255968111 PECOS PAC ID: 9436598992 Enrollment ID: I20240416003615 |
| Provider Name | Cassidy Carter Henriques |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1275029357 PECOS PAC ID: 8527596105 Enrollment ID: I20250109003091 |
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