| Eloise Erasmus PhD LLC | |
|
4141 Old Sibley Memorial Hwy Eagan MN 55122-1996 | |
| (612) 850-0589 | |
| (952) 223-6159 |
| Full Name | Eloise Erasmus PhD LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 4141 Old Sibley Memorial Hwy, Eagan, Minnesota |
| Authorized Official Name and Position | Eloise Erasmus (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 6128500589 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eloise Erasmus PhD LLC 4141 Old Sibley Memorial Hwy Eagan MN 55122-1996 Ph: (612) 850-0589 | Eloise Erasmus PhD LLC 4141 Old Sibley Memorial Hwy Eagan MN 55122-1996 Ph: (612) 850-0589 |
| NPI Number | 1932926631 |
|---|---|
| Provider Enumeration Date | 09/24/2024 |
| Last Update Date | 09/24/2024 |
| Certification Date | 09/24/2024 |
| Medicare PECOS PAC ID | 3870025836 |
|---|---|
| Medicare Enrollment ID | O20241015002575 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932926631 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | () | Primary |
| Provider Name | Eloise Erasmus |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851667067 PECOS PAC ID: 2860649928 Enrollment ID: I20120823000812 |
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