| Expanse - A Minnesota Mental Health Ketamine & Psychedelic Psychother | |
|
2701 University Ave Se Ste 204 Minneapolis MN 55414-3236 | |
| (763) 205-4843 | |
| (612) 416-2085 |
| Full Name | Expanse - A Minnesota Mental Health Ketamine & Psychedelic Psychother |
|---|---|
| Speciality | Clinic/Center |
| Location | 2701 University Ave Se Ste 204, Minneapolis, Minnesota |
| Authorized Official Name and Position | Paula Louise Brandt (PRESIDENT) |
| Authorized Official Contact | 6122960317 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Expanse - A Minnesota Mental Health Ketamine & Psychedelic Psychother 2701 University Ave Se Ste 204 Minneapolis MN 55414-3236 Ph: (763) 205-4843 | Expanse - A Minnesota Mental Health Ketamine & Psychedelic Psychother 2701 University Ave Se Ste 204 Minneapolis MN 55414-3236 Ph: (763) 205-4843 |
| NPI Number | 1528726775 |
|---|---|
| Provider Enumeration Date | 12/06/2021 |
| Last Update Date | 09/26/2025 |
| Certification Date | 09/26/2025 |
| Medicare PECOS PAC ID | 3779940937 |
|---|---|
| Medicare Enrollment ID | O20230601002840 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528726775 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Marc E Mooney |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104960061 PECOS PAC ID: 1951481456 Enrollment ID: I20080109000868 |
| Provider Name | Bruce H Field |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023084076 PECOS PAC ID: 7517092042 Enrollment ID: I20100322000958 |
| Provider Name | Jessica Luehring |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639543556 PECOS PAC ID: 7315242187 Enrollment ID: I20160217000329 |
| Provider Name | Jill M Sweeny |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730200197 PECOS PAC ID: 4183018146 Enrollment ID: I20220308002496 |
| Provider Name | John Lichtsinn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063739266 PECOS PAC ID: 2365809381 Enrollment ID: I20230607001545 |
| Provider Name | Patricia Jean Dickmann |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215256334 PECOS PAC ID: 3870942352 Enrollment ID: I20231208002151 |
| Provider Name | Alexandra B Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891262812 PECOS PAC ID: 4587008586 Enrollment ID: I20240219000015 |
| Provider Name | Alexandra K Chapman |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1801271101 PECOS PAC ID: 4880032705 Enrollment ID: I20240410002715 |
| Provider Name | Kyle William Ross |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528502598 PECOS PAC ID: 3375081086 Enrollment ID: I20240813002068 |
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Phoenix Adolescent Outpatient Treatment Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 601 13th Ave Se, Minneapolis, MN 55414 Phone: 651-734-3268 Fax: 612-378-4886 | |
1-0 Granny's Helpful Hands, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 705 E Lake St, Minneapolis, MN 55407 Phone: 612-824-1177 | |
Community Empowerment Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 333 Washington Ave N, Minneapolis, MN 55401 Phone: 202-450-0351 | |
Kori Hennessy, Ma, Lmft Pa Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4 E 43rd St Ste 201, Minneapolis, MN 55409 Phone: 763-342-0104 | |
Uptown Center For Psychotherapy Ltd Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3253 Humboldt Ave S, Minneapolis, MN 55408 Phone: 920-277-7923 | |
Hennepin County Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1800 Chicago Ave Ste 100, Minneapolis, MN 55404 Phone: 612-879-3115 |