| Integrative Psychological Services, P.a. | |
|
10480 Perkins Ave N Stillwater MN 55082-9273 | |
| (651) 357-3216 | |
| (651) 430-8085 |
| Full Name | Integrative Psychological Services, P.a. |
|---|---|
| Speciality | Psychologist |
| Location | 10480 Perkins Ave N, Stillwater, Minnesota |
| Authorized Official Name and Position | Mary Genevieve Freitag (LICENSED CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 6513573216 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrative Psychological Services, P.a. 10480 Perkins Ave N Stillwater MN 55082-9273 Ph: (651) 357-3216 | Integrative Psychological Services, P.a. 10480 Perkins Ave N Stillwater MN 55082-9273 Ph: (651) 357-3216 |
| NPI Number | 1548465883 |
|---|---|
| Provider Enumeration Date | 06/18/2007 |
| Last Update Date | 11/01/2023 |
| Certification Date | 11/01/2023 |
| Medicare PECOS PAC ID | 2264442482 |
|---|---|
| Medicare Enrollment ID | O20060502000384 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548465883 | NPI | - | NPPES |
| 74G37FR | Other | MN | MENTAL HEALTH |
| 028H0HA | Other | MN | MENTAL HEALTH |
| HP33776 | Other | MN | MENTAL HEALTH |
| 103T00000X | Other | MN | PSYCHOLOGIST |
| 130952 | Other | MN | MENTAL HEALTH |
| 0492456 | Medicaid | MN | |
| 1028022 | Other | MN | MENTAL HEALTH |
| 1382591 | Other | MN | MENTAL HEALTH |
| 61-57516 | Other | MN | MENTAL HEALTH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | LP4319 (Minnesota) | Primary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Mary G Freitag |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447301908 PECOS PAC ID: 8022908755 Enrollment ID: I20040317000706 |
Claudia Bertramsen, M.a., L.p. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 305 Greeley St S, Suite 304, Stillwater, MN 55082 Phone: 651-342-1304 Fax: 651-342-1073 | |
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Canvas Health, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 375 Orleans St E, Stillwater, MN 55082 Phone: 651-430-2727 Fax: 651-351-3155 | |
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