| Carver County | |
|
540 E 1st St Waconia MN 55387-1601 | |
| (952) 442-4437 | |
| (952) 442-3084 |
| Full Name | Carver County |
|---|---|
| Speciality | Clinic/Center |
| Location | 540 E 1st St, Waconia, Minnesota |
| Authorized Official Name and Position | Heather Goodwin (DIRECTOR) |
| Authorized Official Contact | 9523611660 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carver County 540 E 1st St Waconia MN 55387-1601 Ph: (952) 442-4437 | Carver County 540 E 1st St Waconia MN 55387-1601 Ph: (952) 442-4437 |
| NPI Number | 1326049685 |
|---|---|
| Provider Enumeration Date | 08/09/2005 |
| Last Update Date | 06/13/2023 |
| Certification Date | 06/13/2023 |
| Medicare PECOS PAC ID | 8527041961 |
|---|---|
| Medicare Enrollment ID | O20040609000094 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326049685 | NPI | - | NPPES |
| 328T1BE | Other | MN | BEHAVIORAL HEALTHCARE PRO |
| 109639 | Other | MN | U-CARE |
| 51057CA | Other | MN | BLUE CROSS BLUE SHIELD |
| 924555300 | Medicaid | MN | |
| 1017120 | Other | MN | PREFERRED ONE |
| 31377 | Other | MN | HEALTH PARTNERS |
| 9212210 | Other | MN | METROPOLITAN HEALTH PLAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 800823-3-MHC (Minnesota) | Primary |
| Provider Name | Melissa B Hanson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932125861 PECOS PAC ID: 3072681238 Enrollment ID: I20081001000663 |
| Provider Name | Diane H Lawrence |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659503506 PECOS PAC ID: 6204969603 Enrollment ID: I20100805000787 |
| Provider Name | Connie J Gibson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386778918 PECOS PAC ID: 8921272600 Enrollment ID: I20111115000106 |
| Provider Name | Scott A Winker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407858921 PECOS PAC ID: 2860668829 Enrollment ID: I20111222000379 |
| Provider Name | Sharon Letizio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972504041 PECOS PAC ID: 3173799145 Enrollment ID: I20111222000544 |
| Provider Name | Michelle L Purtle |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083846885 PECOS PAC ID: 8729214069 Enrollment ID: I20131115000653 |
| Provider Name | Melanie Jane Warm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891796918 PECOS PAC ID: 6002047743 Enrollment ID: I20140324000635 |
| Provider Name | Lori Jean Wegner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366443715 PECOS PAC ID: 7911120043 Enrollment ID: I20140519001105 |
| Provider Name | Michael C Raguet |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992216188 PECOS PAC ID: 8527325547 Enrollment ID: I20171130000002 |
| Provider Name | Jason G Thymian |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629321716 PECOS PAC ID: 8426396920 Enrollment ID: I20190207001967 |
| Provider Name | Abby Louise Wenzel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225238900 PECOS PAC ID: 4587756820 Enrollment ID: I20190220001628 |
| Provider Name | Marquitta C Trimnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376190793 PECOS PAC ID: 8729310636 Enrollment ID: I20191025002028 |
| Provider Name | Elizabeth S Matoushek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144770322 PECOS PAC ID: 2961833256 Enrollment ID: I20200521001002 |
| Provider Name | Katherine K Jonas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326689225 PECOS PAC ID: 0749607323 Enrollment ID: I20200827001401 |
| Provider Name | Jileen M Tessman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285394932 PECOS PAC ID: 8527452861 Enrollment ID: I20220302000529 |
| Provider Name | Brian Matthew Sager |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972157626 PECOS PAC ID: 3375928419 Enrollment ID: I20220909002852 |
| Provider Name | Amanda J Palmer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962141358 PECOS PAC ID: 7911362264 Enrollment ID: I20230420002207 |
| Provider Name | Christine Dudero |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1255092326 PECOS PAC ID: 9133579774 Enrollment ID: I20231222001950 |
| Provider Name | Charell L Dutton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063079762 PECOS PAC ID: 6002268836 Enrollment ID: I20240117003689 |
| Provider Name | Stacy L Wedding |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740619071 PECOS PAC ID: 0749623213 Enrollment ID: I20240212003239 |
| Provider Name | Eva L Fink |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790184919 PECOS PAC ID: 9739522103 Enrollment ID: I20240213002647 |
| Provider Name | Kelly L Wilkinson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043504145 PECOS PAC ID: 3971946369 Enrollment ID: I20240213003197 |
| Provider Name | Amber E Michels |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154429975 PECOS PAC ID: 0941644926 Enrollment ID: I20240217000604 |
| Provider Name | Aimee M Meligy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831610591 PECOS PAC ID: 5799129672 Enrollment ID: I20240219003342 |
| Provider Name | Heather George |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1003942582 PECOS PAC ID: 6800230632 Enrollment ID: I20240220001516 |
| Provider Name | Tammy Mccarthy |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1629400833 PECOS PAC ID: 9032553698 Enrollment ID: I20240222000833 |
| Provider Name | Ann M Niebuhr |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841844081 PECOS PAC ID: 8426494261 Enrollment ID: I20240315000041 |
Waconia Counseling Services Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1992 Starlight Dr, Waconia, MN 55387 Phone: 612-636-0136 Fax: 952-442-8607 | |
Being While Becoming, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 20 W Main St, Suite 200, Waconia, MN 55387 Phone: 952-649-1202 | |
Haven Chemical Health Systems Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 233 1st St W, Waconia, MN 55387 Phone: 952-442-6227 Fax: 952-442-6228 | |
Clinical And Developmental Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9384 Oak Ave, Waconia, MN 55387 Phone: 952-923-8001 Fax: 952-955-6213 | |
Fireside Counseling Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 9350 Oak Ave, Waconia, MN 55387 Phone: 952-442-0040 | |
Midwest Tms Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1309 Oak Ave Ste 207, Waconia, MN 55387 Phone: 952-442-3828 |