Maple Grove Counseling Center Pa | |
13700 83rd Way Ste 205 Maple Grove MN 55369-7015 | |
(763) 494-8699 | |
(763) 494-8797 |
Full Name | Maple Grove Counseling Center Pa |
---|---|
Speciality | Psychologist |
Location | 13700 83rd Way, Maple Grove, Minnesota |
Authorized Official Name and Position | Ardith Ann Messicci (LICENSED PSYCHOLOGIST OWNER) |
Authorized Official Contact | 7634948699 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Maple Grove Counseling Center Pa 13700 83rd Way Ste 205 Maple Grove MN 55369-7015 Ph: (763) 494-8699 | Maple Grove Counseling Center Pa 13700 83rd Way Ste 205 Maple Grove MN 55369-7015 Ph: (763) 494-8699 |
NPI Number | 1164496071 |
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Provider Enumeration Date | 02/15/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164496071 | NPI | - | NPPES |
3H755ME | Other | MN | BCBS |
88297 | Other | MN | ARAZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | LP0951 (Minnesota) | Primary |
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