| Minnesota Renewal Center | |
|
3499 Lexington Ave N Suite 100 St. Paul MN 55126-7058 | |
| (651) 486-4828 | |
| (651) 482-9119 |
| Full Name | Minnesota Renewal Center |
|---|---|
| Speciality | Counselor |
| Location | 3499 Lexington Ave N, St. Paul, Minnesota |
| Authorized Official Name and Position | Amanda Cook (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6514864828 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Minnesota Renewal Center 3499 Lexington Ave. N Suite 100 St. Paul MN 55126-7058 Ph: (651) 486-4828 | Minnesota Renewal Center 3499 Lexington Ave N Suite 100 St. Paul MN 55126-7058 Ph: (651) 486-4828 |
| NPI Number | 1326165630 |
|---|---|
| Provider Enumeration Date | 03/23/2007 |
| Last Update Date | 05/03/2024 |
| Certification Date | 05/03/2024 |
| Medicare PECOS PAC ID | 0749723286 |
|---|---|
| Medicare Enrollment ID | O20240625001353 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326165630 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Secondary |
| Provider Name | Jeffrey Scott Berryhill |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184706350 PECOS PAC ID: 1658640065 Enrollment ID: I20170628001150 |
| Provider Name | Elisa Horning |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538779749 PECOS PAC ID: 5597208512 Enrollment ID: I20240619000496 |
| Provider Name | Deborah Klaver |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1457564924 PECOS PAC ID: 6305389230 Enrollment ID: I20240620002248 |
| Provider Name | Trisha Wohlfeil |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1154669836 PECOS PAC ID: 0143763946 Enrollment ID: I20240621000701 |
| Provider Name | Sharon L Mason |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962513713 PECOS PAC ID: 7719422799 Enrollment ID: I20240715001404 |
| Provider Name | Amanda K Cook |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1720341134 PECOS PAC ID: 8527417021 Enrollment ID: I20240830002538 |
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