| Ervin Counseling And Family Life Ministries, P.a. | |
|
7400 Metro Blvd Ste 220 Edina MN 55439-2321 | |
| (952) 345-4510 | |
| (952) 345-4518 |
| Full Name | Ervin Counseling And Family Life Ministries, P.a. |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 7400 Metro Blvd Ste 220, Edina, Minnesota |
| Authorized Official Name and Position | Bruce David Ervin (PRESIDENT) |
| Authorized Official Contact | 9523454510 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ervin Counseling And Family Life Ministries, P.a. 7400 Metro Blvd Ste 220 Edina MN 55439-2321 Ph: (952) 345-4510 | Ervin Counseling And Family Life Ministries, P.a. 7400 Metro Blvd Ste 220 Edina MN 55439-2321 Ph: (952) 345-4510 |
| NPI Number | 1497880108 |
|---|---|
| Provider Enumeration Date | 02/22/2007 |
| Last Update Date | 05/04/2024 |
| Certification Date | 05/04/2024 |
| Medicare PECOS PAC ID | 8820530009 |
|---|---|
| Medicare Enrollment ID | O20240603003186 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497880108 | NPI | - | NPPES |
| 180P7ER | Other | MN | BCBSM GROUP PROVIDER # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 1114 (Minnesota) | Primary |
| Provider Name | Lisa Jean Ervin |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1891816260 PECOS PAC ID: 4284176462 Enrollment ID: I20240603003275 |
| Provider Name | Bruce David Ervin |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1669598728 PECOS PAC ID: 3375085558 Enrollment ID: I20240705000717 |
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