| Independent Management Services Of Mn, Inc. | |
|
101 21st St Se Ste 1 Austin MN 55912-4322 | |
| (507) 437-6389 | |
| (507) 437-0977 |
| Full Name | Independent Management Services Of Mn, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 101 21st St Se Ste 1, Austin, Minnesota |
| Authorized Official Name and Position | Ryan Thomas Thorson (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5074376389 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Independent Management Services Of Mn, Inc. 101 21st St Se Ste 1 Austin MN 55912-4322 Ph: (507) 437-6389 | Independent Management Services Of Mn, Inc. 101 21st St Se Ste 1 Austin MN 55912-4322 Ph: (507) 437-6389 |
| NPI Number | 1255472957 |
|---|---|
| Provider Enumeration Date | 02/08/2007 |
| Last Update Date | 11/20/2024 |
| Certification Date | 11/20/2024 |
| Medicare PECOS PAC ID | 1658674775 |
|---|---|
| Medicare Enrollment ID | O20160125000954 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255472957 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Ryan Thomas Thorson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225326705 PECOS PAC ID: 0042451635 Enrollment ID: I20160201000322 |
| Provider Name | Melissa Sue Haldeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144092743 PECOS PAC ID: 5496192155 Enrollment ID: I20240318002649 |
| Provider Name | Ashley Marie Schoonover |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770223109 PECOS PAC ID: 0840709077 Enrollment ID: I20250530001634 |
| Provider Name | Heather A Peterson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841844396 PECOS PAC ID: 2860901931 Enrollment ID: I20250530002700 |
| Provider Name | Karlie Anne Hall |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336957075 PECOS PAC ID: 3173032810 Enrollment ID: I20250603003643 |
| Provider Name | Cody Joseph Shea |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770367815 PECOS PAC ID: 6305357617 Enrollment ID: I20250613003076 |
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