| Eagan Counseling Clinic | |
|
3450 Oleary Ln Eagan MN 55123-2340 | |
| (651) 454-0114 | |
| (651) 454-3492 |
| Full Name | Eagan Counseling Clinic |
|---|---|
| Speciality | Psychologist |
| Location | 3450 Oleary Ln, Eagan, Minnesota |
| Authorized Official Name and Position | Peggy Dominic (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 6513658217 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eagan Counseling Clinic 3450 Oleary Ln Eagan MN 55123-2340 Ph: (651) 454-0114 | Eagan Counseling Clinic 3450 Oleary Ln Eagan MN 55123-2340 Ph: (651) 454-0114 |
| NPI Number | 1144311184 |
|---|---|
| Provider Enumeration Date | 09/27/2006 |
| Last Update Date | 04/10/2008 |
| Medicare PECOS PAC ID | 2860304045 |
|---|---|
| Medicare Enrollment ID | O20031105000326 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144311184 | NPI | - | NPPES |
| 800084 | Other | MN | PREFERRED ONE |
| 59280EA | Other | MN | BCBS |
| 00892 | Other | MN | HEALTH PARTNERS |
| 101973 | Other | MN | UCARE |
| 84-57408 | Other | MN | MEDICA |
| Provider Name | Daniel C Thomason |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629093380 PECOS PAC ID: 4183663537 Enrollment ID: I20050426000946 |
| Provider Name | Sujit R Varma |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013018258 PECOS PAC ID: 0840224002 Enrollment ID: I20050927000227 |
| Provider Name | Gary Lee Norman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972644581 PECOS PAC ID: 9537256508 Enrollment ID: I20071107000795 |
| Provider Name | Michael A Donndelinger-beldon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740329234 PECOS PAC ID: 4082771084 Enrollment ID: I20090318000466 |
| Provider Name | Michelle M Tichey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578595492 PECOS PAC ID: 1153450531 Enrollment ID: I20100524000142 |
| Provider Name | Anastasia L Cyptar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376663963 PECOS PAC ID: 1254526791 Enrollment ID: I20101110001005 |
| Provider Name | Molly Cronin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235221441 PECOS PAC ID: 1355516790 Enrollment ID: I20111213000412 |
| Provider Name | Patrick M Doyle |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700978061 PECOS PAC ID: 4082526264 Enrollment ID: I20120131000370 |
| Provider Name | Lisa Marie Sorenson-woodhull |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215021266 PECOS PAC ID: 5092972166 Enrollment ID: I20120201000039 |
| Provider Name | Kathleen M Sprole |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770887689 PECOS PAC ID: 5991962383 Enrollment ID: I20120214000462 |
| Provider Name | Rebecca L Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851708259 PECOS PAC ID: 9032331269 Enrollment ID: I20141104000495 |
| Provider Name | Meghan D Miller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225377088 PECOS PAC ID: 7416273594 Enrollment ID: I20150309000774 |
| Provider Name | Alex Nc Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578802336 PECOS PAC ID: 9436465705 Enrollment ID: I20150901001578 |
| Provider Name | Elizabeth Islay Mcpeek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093191603 PECOS PAC ID: 3678883048 Enrollment ID: I20151116000428 |
| Provider Name | Amy L Jacky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922437334 PECOS PAC ID: 4183852478 Enrollment ID: I20160719002800 |
| Provider Name | Miranda B Dulek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356896765 PECOS PAC ID: 3678860319 Enrollment ID: I20160923002114 |
| Provider Name | Ciara L Stigen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033562137 PECOS PAC ID: 4880982818 Enrollment ID: I20161007000044 |
| Provider Name | Ann C Fasching |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376044149 PECOS PAC ID: 9133474810 Enrollment ID: I20180620003264 |
| Provider Name | Natalie N Brandsrud |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043797848 PECOS PAC ID: 5092064428 Enrollment ID: I20180820000030 |
| Provider Name | Dustin M Jacob |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376967570 PECOS PAC ID: 2264664267 Enrollment ID: I20180821000748 |
| Provider Name | Richard Edwin Close |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457379026 PECOS PAC ID: 9739433970 Enrollment ID: I20181107000624 |
| Provider Name | Elise B Quam |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891269155 PECOS PAC ID: 7810238367 Enrollment ID: I20190409003460 |
| Provider Name | Jessica D Maryniuk |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396140422 PECOS PAC ID: 1850632324 Enrollment ID: I20190410000992 |
| Provider Name | Danielle L Kuka |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568937092 PECOS PAC ID: 2163763657 Enrollment ID: I20190410001704 |
| Provider Name | Lauren E Daniel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164899944 PECOS PAC ID: 9537400056 Enrollment ID: I20190412001827 |
| Provider Name | Melissa Mary Conway |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518526631 PECOS PAC ID: 0143559021 Enrollment ID: I20190903002315 |
| Provider Name | Joshua Hampton Goodwin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730733098 PECOS PAC ID: 6507196201 Enrollment ID: I20190923003261 |
| Provider Name | Brigit M Kotzky |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265780191 PECOS PAC ID: 9739513532 Enrollment ID: I20200103001195 |
| Provider Name | Kaibeh Benson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265065114 PECOS PAC ID: 1052741865 Enrollment ID: I20200420000216 |
| Provider Name | Ellen C Solis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922560788 PECOS PAC ID: 4385067164 Enrollment ID: I20200713001635 |
| Provider Name | Lisa J Rutman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194334318 PECOS PAC ID: 5395163984 Enrollment ID: I20200914002255 |
| Provider Name | Emiily E Glover |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033630967 PECOS PAC ID: 5193136901 Enrollment ID: I20201201000244 |
| Provider Name | Shane M Hamp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326655093 PECOS PAC ID: 2264843960 Enrollment ID: I20201202001043 |
| Provider Name | Venus L Burney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942649173 PECOS PAC ID: 1254743651 Enrollment ID: I20201208002897 |
| Provider Name | Emmanuelle E Hansen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184200065 PECOS PAC ID: 7517366818 Enrollment ID: I20210518002085 |
| Provider Name | Avery R Luft |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053823294 PECOS PAC ID: 8921356866 Enrollment ID: I20210630003124 |
| Provider Name | Kiah G Staloch |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619344900 PECOS PAC ID: 0749682011 Enrollment ID: I20210708002411 |
| Provider Name | Kimberly R Debeer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437822558 PECOS PAC ID: 1355746702 Enrollment ID: I20210823002023 |
| Provider Name | Kristin Marie Hazen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265809511 PECOS PAC ID: 6800285636 Enrollment ID: I20211116001262 |
| Provider Name | Lindsey Nicole Job |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245949320 PECOS PAC ID: 3072983642 Enrollment ID: I20221226000128 |
| Provider Name | Laurie M Wollman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992485130 PECOS PAC ID: 4486018611 Enrollment ID: I20230906003832 |
| Provider Name | Christina Heather Owens |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720671357 PECOS PAC ID: 4385094556 Enrollment ID: I20231229002228 |
| Provider Name | Angela K Krebs |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1508910530 PECOS PAC ID: 3274984331 Enrollment ID: I20240112002826 |
| Provider Name | Daniel B Redman |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1669962510 PECOS PAC ID: 6800274200 Enrollment ID: I20240116001184 |
| Provider Name | Sharon A Flom |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1689449209 PECOS PAC ID: 0547612186 Enrollment ID: I20240118003247 |
| Provider Name | Jeannine M Batchelder |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1306465596 PECOS PAC ID: 9739531229 Enrollment ID: I20240119003712 |
| Provider Name | Sydney R Keeler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164004479 PECOS PAC ID: 1951753821 Enrollment ID: I20240126003147 |
| Provider Name | Kathryn T Reinholdt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790311801 PECOS PAC ID: 3971955980 Enrollment ID: I20240131002430 |
| Provider Name | Amber L Schupp |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720215171 PECOS PAC ID: 7012369085 Enrollment ID: I20240131002769 |
| Provider Name | Heather E Oleson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518324706 PECOS PAC ID: 7618329640 Enrollment ID: I20240205001633 |
| Provider Name | Laura K Jayroe |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053184267 PECOS PAC ID: 3870936065 Enrollment ID: I20240205001888 |
| Provider Name | Scarlett H O'connell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073388542 PECOS PAC ID: 8820431034 Enrollment ID: I20240205002461 |
| Provider Name | Callie K Peterson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1134817042 PECOS PAC ID: 6406299627 Enrollment ID: I20240205002999 |
| Provider Name | Lawrene L Sedlacek |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093288987 PECOS PAC ID: 6204279433 Enrollment ID: I20240205003091 |
| Provider Name | Carol S Elstad |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518574672 PECOS PAC ID: 6305295023 Enrollment ID: I20240206001672 |
| Provider Name | Angela M Schaefer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609120146 PECOS PAC ID: 6002250289 Enrollment ID: I20240215001689 |
| Provider Name | Benjamin James Thompson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689941122 PECOS PAC ID: 2365887643 Enrollment ID: I20240226003661 |
| Provider Name | Janel M Oberg |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023427226 PECOS PAC ID: 3173974482 Enrollment ID: I20240228000163 |
| Provider Name | Brian L Nelson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669930012 PECOS PAC ID: 5496106635 Enrollment ID: I20240228001077 |
| Provider Name | Mara J Fusco |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568949774 PECOS PAC ID: 3678922390 Enrollment ID: I20240301002941 |
| Provider Name | Matthew S Carlson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023290632 PECOS PAC ID: 3476902727 Enrollment ID: I20240304000314 |
| Provider Name | Mary A Freitag |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992369664 PECOS PAC ID: 7416306808 Enrollment ID: I20240307000513 |
| Provider Name | Laura Ellen Mitchell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417668625 PECOS PAC ID: 3577900745 Enrollment ID: I20240322003774 |
| Provider Name | Alfred C Jaryan |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1679155477 PECOS PAC ID: 1557709672 Enrollment ID: I20240409000900 |
| Provider Name | Jennifer E Hoffman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023888625 PECOS PAC ID: 1254779390 Enrollment ID: I20240409000973 |
| Provider Name | Karen S Slaght |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326219106 PECOS PAC ID: 5890137202 Enrollment ID: I20240530000464 |
| Provider Name | Jennifer C Johnston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578249835 PECOS PAC ID: 0446692727 Enrollment ID: I20240531003191 |
| Provider Name | Alexis M Kruggel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184484073 PECOS PAC ID: 1153863675 Enrollment ID: I20240611003752 |
| Provider Name | Megan E Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710510888 PECOS PAC ID: 9032651526 Enrollment ID: I20240612001820 |
| Provider Name | Jordan Haight |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619637998 PECOS PAC ID: 1355885054 Enrollment ID: I20240705002263 |
| Provider Name | Brittni L Kordonowy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689313488 PECOS PAC ID: 0042754624 Enrollment ID: I20240708001186 |
| Provider Name | Jennifer D Poaches |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427404821 PECOS PAC ID: 7113462755 Enrollment ID: I20240708003629 |
| Provider Name | Tracy L Emmick |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1952838401 PECOS PAC ID: 0749727436 Enrollment ID: I20240730003871 |
| Provider Name | Leah L Bonine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407410715 PECOS PAC ID: 4981141470 Enrollment ID: I20240801002544 |
| Provider Name | Nicole Fisher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902213705 PECOS PAC ID: 6507309242 Enrollment ID: I20240916001224 |
| Provider Name | Tanya M Howard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801654454 PECOS PAC ID: 5698216612 Enrollment ID: I20240918001359 |
| Provider Name | Bailey N Schaal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194546101 PECOS PAC ID: 6901331925 Enrollment ID: I20241127000551 |
| Provider Name | Beth M Al-qudah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518534833 PECOS PAC ID: 2668900150 Enrollment ID: I20250113000086 |
| Provider Name | Holland R Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225844228 PECOS PAC ID: 6800324302 Enrollment ID: I20250113000225 |
| Provider Name | Maria L Phelps |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1528608874 PECOS PAC ID: 5799213179 Enrollment ID: I20250113002973 |
| Provider Name | Sydney R Pierce |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801600689 PECOS PAC ID: 2769906593 Enrollment ID: I20250414001599 |
| Provider Name | Sophia L Meierding |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205575057 PECOS PAC ID: 8527587922 Enrollment ID: I20250529001045 |
Leslie K Adair Psychological Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1121 Town Centre Dr Ste 202, Eagan, MN 55123 Phone: 612-978-1852 Fax: 651-615-2328 | |
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Twin Cities Play Therapy Center, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3440 Federal Dr, Suite 140, Eagan, MN 55122 Phone: 651-452-2305 Fax: 651-452-2796 | |
Denae Ruble Lmft Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4660 Slater Rd Ste 220d, Eagan, MN 55122 Phone: 612-940-2102 | |
Voyageurs Counseling Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3440 Federal Dr Ste 155, Eagan, MN 55122 Phone: 952-232-1716 | |
Wave Comfort Care Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 860 Blue Gentian Rd Ste 200, Eagan, MN 55121 Phone: 612-226-7786 Fax: 612-226-7786 | |
Minnesota Mental Health Clinics Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3450 Oleary Ln, Eagan, MN 55123 Phone: 651-454-0114 Fax: 651-454-3492 |