| Mesm, Llc | |
|
11224 86th Ave N Maple Grove MN 55369-4510 | |
| (763) 400-7077 | |
| (763) 400-7078 |
| Full Name | Mesm, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 11224 86th Ave N, Maple Grove, Minnesota |
| Authorized Official Name and Position | Margot Storti-marron (OWNER, PSYCHOTHERAPIST) |
| Authorized Official Contact | 7634007077 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mesm, Llc 16460 78th Ave N Maple Grove MN 55311 Ph: (763) 416-6350 | Mesm, Llc 11224 86th Ave N Maple Grove MN 55369-4510 Ph: (763) 400-7077 |
| NPI Number | 1467975607 |
|---|---|
| Provider Enumeration Date | 07/19/2017 |
| Last Update Date | 06/11/2019 |
| Medicare PECOS PAC ID | 2567703317 |
|---|---|
| Medicare Enrollment ID | O20190404002471 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467975607 | NPI | - | NPPES |
| 1528159860 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 06884 (Minnesota) | Primary |
| Provider Name | Margot Elaine Storti-marron |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528159860 PECOS PAC ID: 4486979267 Enrollment ID: I20150219001556 |
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