| Life Essentials Psychology Llc | |
|
13750 Crosstown Dr Nw Ste 10 Andover MN 55304-5853 | |
| (763) 317-8255 | |
| (855) 913-2522 |
| Full Name | Life Essentials Psychology Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 13750 Crosstown Dr Nw Ste 10, Andover, Minnesota |
| Authorized Official Name and Position | Thao-ha Phan (MEMBER) |
| Authorized Official Contact | 7633178255 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Essentials Psychology Llc 13750 Crosstown Dr Nw Ste 10 Andover MN 55304-5853 Ph: (763) 317-8255 | Life Essentials Psychology Llc 13750 Crosstown Dr Nw Ste 10 Andover MN 55304-5853 Ph: (763) 317-8255 |
| NPI Number | 1124572235 |
|---|---|
| Provider Enumeration Date | 08/05/2016 |
| Last Update Date | 10/10/2025 |
| Certification Date | 10/10/2025 |
| Medicare PECOS PAC ID | 0244632347 |
|---|---|
| Medicare Enrollment ID | O20210713000359 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124572235 | NPI | - | NPPES |
| 1124572235 | Medicaid | MN |
| Provider Name | Thao-ha Phan |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1477919025 PECOS PAC ID: 3971905076 Enrollment ID: I20240430003089 |
| Provider Name | Kimberley Wobschall |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1003232638 PECOS PAC ID: 3870039472 Enrollment ID: I20240718004672 |
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