| Authentic Self Therapy Pllc | |
|
407 Cedarwood Ct Waite Park MN 56387-4504 | |
| (701) 552-2992 | |
| Not Available |
| Full Name | Authentic Self Therapy Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 407 Cedarwood Ct, Waite Park, Minnesota |
| Authorized Official Name and Position | Nicolette R Johnson (THERAPIST) |
| Authorized Official Contact | 7015522992 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Authentic Self Therapy Pllc 407 Cedarwood Ct Waite Park MN 56387-4504 Ph: (701) 552-2992 | Authentic Self Therapy Pllc 407 Cedarwood Ct Waite Park MN 56387-4504 Ph: (701) 552-2992 |
| NPI Number | 1255013504 |
|---|---|
| Provider Enumeration Date | 08/07/2023 |
| Last Update Date | 08/07/2023 |
| Certification Date | 08/05/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255013504 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Cos Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 384 3rd St Ne, Waite Park, MN 56387 Phone: 320-250-9188 Fax: 320-396-7300 | |
Market Place Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 2nd St S, Suite 303, Waite Park, MN 56387 Phone: 320-253-4080 Fax: 320-253-4088 | |
Marketplace Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 2nd St S Ste 303, Waite Park, MN 56387 Phone: 320-253-4080 Fax: 320-253-4088 | |
Jennifer L. Miller, Ph.d., Lp, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 110 2nd St S Ste 303, Waite Park, MN 56387 Phone: 320-217-6025 Fax: 320-774-3005 | |
Kathryn Laakso Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 2nd St S, Suite 304, Waite Park, MN 56387 Phone: 320-253-4080 Fax: 329-253-4088 | |
Avitity, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 315 Waite Ave S, Suite 301, Waite Park, MN 56387 Phone: 612-249-3656 |