| Lake And Valley Family Therapy Llc | |
|
2179 4th St Ste 2f White Bear Lake MN 55110-3041 | |
| (651) 360-1995 | |
| (651) 666-1379 |
| Full Name | Lake And Valley Family Therapy Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 2179 4th St Ste 2f, White Bear Lake, Minnesota |
| Authorized Official Name and Position | Natasha Keller (OWNER) |
| Authorized Official Contact | 6513601995 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake And Valley Family Therapy Llc 2179 4th St Ste 2b White Bear Lake MN 55110-3041 Ph: (651) 360-1995 | Lake And Valley Family Therapy Llc 2179 4th St Ste 2f White Bear Lake MN 55110-3041 Ph: (651) 360-1995 |
| NPI Number | 1578262333 |
|---|---|
| Provider Enumeration Date | 03/01/2023 |
| Last Update Date | 03/11/2025 |
| Certification Date | 03/11/2025 |
| Medicare PECOS PAC ID | 5193249449 |
|---|---|
| Medicare Enrollment ID | O20250408001553 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578262333 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Natasha Ann Keller |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1578179727 PECOS PAC ID: 6002330354 Enrollment ID: I20250408001680 |
| Provider Name | Timothy Roylance Lindwall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992561690 PECOS PAC ID: 8921526542 Enrollment ID: I20250519000316 |
| Provider Name | Brittany Taylor Reading |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255998050 PECOS PAC ID: 9931627320 Enrollment ID: I20250520000281 |
| Provider Name | Diana Sue Finney |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003506577 PECOS PAC ID: 0446760664 Enrollment ID: I20250606003232 |
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