| Minnesota Online Counseling Llc | |
|
1310 Highway 96 E Suite 104c White Bear Lake MN 55110-3624 | |
| (651) 336-6942 | |
| Not Available |
| Full Name | Minnesota Online Counseling Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 1310 Highway 96 E, White Bear Lake, Minnesota |
| Authorized Official Name and Position | David Halper (MANAGING MEMBER) |
| Authorized Official Contact | 6513366942 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Minnesota Online Counseling Llc 6808 Upper 28th St N Oakdale MN 55128-3833 Ph: (651) 336-6942 | Minnesota Online Counseling Llc 1310 Highway 96 E Suite 104c White Bear Lake MN 55110-3624 Ph: (651) 336-6942 |
| NPI Number | 1609255694 |
|---|---|
| Provider Enumeration Date | 05/22/2015 |
| Last Update Date | 05/22/2015 |
| Medicare PECOS PAC ID | 3072849207 |
|---|---|
| Medicare Enrollment ID | O20190725003486 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609255694 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Mary Young Sa |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912095761 PECOS PAC ID: 6608815154 Enrollment ID: I20050426000120 |
| Provider Name | Melissa Anne Raatz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942778022 PECOS PAC ID: 4284050105 Enrollment ID: I20210223003240 |
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