| Life Essentials Psychology Llc | |
|
13750 Crosstown Dr Nw Ste 206 Andover MN 55304-5856 | |
| (763) 317-8255 | |
| (888) 972-1656 |
| Full Name | Life Essentials Psychology Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 13750 Crosstown Dr Nw Ste 206, 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 206 Andover MN 55304-5856 Ph: (763) 317-8255 | Life Essentials Psychology Llc 13750 Crosstown Dr Nw Ste 206 Andover MN 55304-5856 Ph: (763) 317-8255 |
| NPI Number | 1124572235 |
|---|---|
| Provider Enumeration Date | 08/05/2016 |
| Last Update Date | 02/28/2022 |
| Certification Date | 02/28/2022 |
| Medicare PECOS PAC ID | 0244632347 |
|---|---|
| Medicare Enrollment ID | O20210713000359 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124572235 | NPI | - | NPPES |
| Provider Name | Rachael Sarto |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407224652 PECOS PAC ID: 3971813924 Enrollment ID: I20151104000644 |
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