| Kathleen Anderson Ms Lmft Llc | |
|
15088 22nd Ave Ne # 101 Little Falls MN 56345-4199 | |
| (320) 224-1853 | |
| Not Available |
| Full Name | Kathleen Anderson Ms Lmft Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 15088 22nd Ave Ne # 101, Little Falls, Minnesota |
| Authorized Official Name and Position | Kathleen Anderson (OWNER) |
| Authorized Official Contact | 3202241853 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kathleen Anderson Ms Lmft Llc 14949 Sandpiper Dr Little Falls MN 56345-3394 Ph: (320) 224-1853 | Kathleen Anderson Ms Lmft Llc 15088 22nd Ave Ne # 101 Little Falls MN 56345-4199 Ph: (320) 224-1853 |
| NPI Number | 1649844382 |
|---|---|
| Provider Enumeration Date | 05/17/2021 |
| Last Update Date | 05/17/2021 |
| Certification Date | 05/17/2021 |
| Medicare PECOS PAC ID | 3779926605 |
|---|---|
| Medicare Enrollment ID | O20240208000308 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649844382 | NPI | - | NPPES |
| 1750687406 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Kathleen Mary Anderson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1750687406 PECOS PAC ID: 4688017510 Enrollment ID: I20240208000335 |
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