| Conscious Healing Counseling Inc | |
|
2705 Bunker Lake Blvd Nw Ste 112 Andover MN 55304-3785 | |
| (815) 973-0999 | |
| Not Available |
| Full Name | Conscious Healing Counseling Inc |
|---|---|
| Speciality | Counselor |
| Location | 2705 Bunker Lake Blvd Nw Ste 112, Andover, Minnesota |
| Authorized Official Name and Position | Jamie Lynn Mosley (THERAPIST) |
| Authorized Official Contact | 8159730999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Conscious Healing Counseling Inc 20495 Gadwall Ln Rogers MN 55374-8767 Ph: (815) 973-0999 | Conscious Healing Counseling Inc 2705 Bunker Lake Blvd Nw Ste 112 Andover MN 55304-3785 Ph: (815) 973-0999 |
| NPI Number | 1366944597 |
|---|---|
| Provider Enumeration Date | 03/04/2018 |
| Last Update Date | 05/13/2020 |
| Certification Date | 05/13/2020 |
| Medicare PECOS PAC ID | 4688095268 |
|---|---|
| Medicare Enrollment ID | O20200608000853 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366944597 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | CC01259 (Minnesota) | Primary |
| Provider Name | Richelle R Amundson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437609328 PECOS PAC ID: 5890074165 Enrollment ID: I20161110000032 |
| Provider Name | Sarah Renee June Sumner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265998819 PECOS PAC ID: 8527478015 Enrollment ID: I20201112001766 |
| Provider Name | Alea Joy Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689119539 PECOS PAC ID: 5698177939 Enrollment ID: I20210709000774 |
| Provider Name | Tara L Floersch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790460186 PECOS PAC ID: 4183079692 Enrollment ID: I20231018000581 |
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