| Elizabeth Shreve Inc. | |
|
825 Berry St Apt 102 Saint Paul MN 55114-1168 | |
| (612) 203-8437 | |
| Not Available |
| Full Name | Elizabeth Shreve Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 825 Berry St Apt 102, Saint Paul, Minnesota |
| Authorized Official Name and Position | Elizabeth Shreve (OWNER) |
| Authorized Official Contact | 6122038437 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elizabeth Shreve Inc. 825 Berry St Apt 102 Saint Paul MN 55114-1168 Ph: (612) 203-8437 | Elizabeth Shreve Inc. 825 Berry St Apt 102 Saint Paul MN 55114-1168 Ph: (612) 203-8437 |
| NPI Number | 1457076424 |
|---|---|
| Provider Enumeration Date | 10/11/2022 |
| Last Update Date | 10/11/2022 |
| Certification Date | 10/11/2022 |
| Medicare PECOS PAC ID | 7416327499 |
|---|---|
| Medicare Enrollment ID | O20230109001882 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457076424 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Elizabeth Henderson Shreve |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366766032 PECOS PAC ID: 1052555679 Enrollment ID: I20130923000339 |
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