| Jewish Family Service Of St. Paul | |
|
1633 7th St W Saint Paul MN 55102-4227 | |
| (651) 698-0767 | |
| (651) 698-0162 |
| Full Name | Jewish Family Service Of St. Paul |
|---|---|
| Speciality | Case Management |
| Location | 1633 7th St W, Saint Paul, Minnesota |
| Authorized Official Name and Position | Rena Waxman (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6516980767 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jewish Family Service Of St. Paul 1633 - 7th St. W. St. Paul MN 55102 Ph: (651) 698-0767 | Jewish Family Service Of St. Paul 1633 7th St W Saint Paul MN 55102-4227 Ph: (651) 698-0767 |
| NPI Number | 1821165234 |
|---|---|
| Provider Enumeration Date | 11/29/2006 |
| Last Update Date | 09/11/2025 |
| Medicare PECOS PAC ID | 5092896936 |
|---|---|
| Medicare Enrollment ID | O20080116000591 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821165234 | NPI | - | NPPES |
| 104817100 | Other | MN | RAMSEY COUNTY ID # |
| 510079800 | Other | MN | RAMSEY COUNTY ID #2 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Minnesota) | Secondary |
| 251B00000X | Case Management | (Minnesota) | Primary |
| Provider Name | Mitchell T Wittenberg |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457429466 PECOS PAC ID: 4688861842 Enrollment ID: I20101214000668 |
| Provider Name | Stephanie Larson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740875608 PECOS PAC ID: 6305213471 Enrollment ID: I20221102000660 |
| Provider Name | Tara Burns |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982307583 PECOS PAC ID: 1254776461 Enrollment ID: I20240228000064 |
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