| Gray Matters Therapy Llc | |
|
100 Latsch Sq Ste 203 Winona MN 55987-2995 | |
| (515) 710-4002 | |
| Not Available |
| Full Name | Gray Matters Therapy Llc |
|---|---|
| Speciality | Counselor |
| Location | 100 Latsch Sq Ste 203, Winona, Minnesota |
| Authorized Official Name and Position | Michael Donnenwerth (BUSINESS MANAGER) |
| Authorized Official Contact | 5074507091 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gray Matters Therapy Llc 100 Latsch Sq Ste 203 Winona MN 55987-2995 Ph: (515) 710-4002 | Gray Matters Therapy Llc 100 Latsch Sq Ste 203 Winona MN 55987-2995 Ph: (515) 710-4002 |
| NPI Number | 1720894710 |
|---|---|
| Provider Enumeration Date | 12/05/2024 |
| Last Update Date | 12/09/2024 |
| Certification Date | 12/09/2024 |
| Medicare PECOS PAC ID | 4587191903 |
|---|---|
| Medicare Enrollment ID | O20241226000931 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720894710 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Amy Donnenwerth |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528711892 PECOS PAC ID: 5496282816 Enrollment ID: I20241226001064 |
| Provider Name | Kathleen Grace Karnick |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912403288 PECOS PAC ID: 8022539881 Enrollment ID: I20250310001156 |
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