| Lutheran Social Service Of Minnesota | |
|
22 Wilson Ave Ne Ste 110 Saint Cloud MN 56304-0440 | |
| (320) 251-7700 | |
| (320) 251-8898 |
| Full Name | Lutheran Social Service Of Minnesota |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 22 Wilson Ave Ne Ste 110, Saint Cloud, Minnesota |
| Authorized Official Name and Position | Brigid Peterson (CHIEF COMPLIANCE OFFICER) |
| Authorized Official Contact | 6513109451 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lutheran Social Service Of Minnesota 2485 Como Ave Saint Paul MN 55108-1445 Ph: (800) 582-5260 | Lutheran Social Service Of Minnesota 22 Wilson Ave Ne Ste 110 Saint Cloud MN 56304-0440 Ph: (320) 251-7700 |
| NPI Number | 1629192430 |
|---|---|
| Provider Enumeration Date | 03/19/2007 |
| Last Update Date | 02/24/2017 |
| Medicare PECOS PAC ID | 1951202019 |
|---|---|
| Medicare Enrollment ID | O20040205000477 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629192430 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Jan R Haugrud |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821187915 PECOS PAC ID: 7618162785 Enrollment ID: I20101115000857 |
| Provider Name | Laura J Skogen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164599767 PECOS PAC ID: 8527234855 Enrollment ID: I20120106000819 |
| Provider Name | Sarah K Schroeder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144503061 PECOS PAC ID: 6608024922 Enrollment ID: I20120912000025 |
| Provider Name | Sharon E Odland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013211820 PECOS PAC ID: 5092948695 Enrollment ID: I20140506001970 |
| Provider Name | Kari S Duong-topp |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689138901 PECOS PAC ID: 8921349432 Enrollment ID: I20190410002329 |
| Provider Name | Kay Ann Kinkel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639588437 PECOS PAC ID: 6709212731 Enrollment ID: I20200211001609 |
| Provider Name | Kayle N Erickson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225679343 PECOS PAC ID: 3173959970 Enrollment ID: I20200213001542 |
| Provider Name | Casey J Petek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962083964 PECOS PAC ID: 1456751015 Enrollment ID: I20210618000536 |
| Provider Name | Tori P Clark |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184220725 PECOS PAC ID: 9931503851 Enrollment ID: I20210813001604 |
| Provider Name | Elizabeth Anne Nebeker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508578642 PECOS PAC ID: 2264804269 Enrollment ID: I20230220001381 |
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