| Mn Mental Health Consulting Llc | |
|
7600 Parklawn Ave #380 Edina MN 55435 | |
| (612) 203-2961 | |
| (952) 831-0033 |
| Full Name | Mn Mental Health Consulting Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 7600 Parklawn Ave, Edina, Minnesota |
| Authorized Official Name and Position | Michelle C Peterson (THERAPIST) |
| Authorized Official Contact | 6122032961 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mn Mental Health Consulting Llc 7600 Parklawn Ave #380 Edina MN 55435-5125 Ph: (612) 203-2961 | Mn Mental Health Consulting Llc 7600 Parklawn Ave #380 Edina MN 55435 Ph: (612) 203-2961 |
| NPI Number | 1639343783 |
|---|---|
| Provider Enumeration Date | 04/19/2008 |
| Last Update Date | 06/01/2021 |
| Certification Date | 06/01/2021 |
| Medicare PECOS PAC ID | 9739344227 |
|---|---|
| Medicare Enrollment ID | O20120709000161 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639343783 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1315 (Minnesota) | Primary |
| Provider Name | Tena B Roethle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821223793 PECOS PAC ID: 5799941845 Enrollment ID: I20120718000517 |
| Provider Name | Michelle C Peterson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1851354153 PECOS PAC ID: 8628233111 Enrollment ID: I20240212000804 |
| Provider Name | John M Lampert |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1801038989 PECOS PAC ID: 0840635462 Enrollment ID: I20240305001445 |
| Provider Name | Jessica S Conners |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1902413834 PECOS PAC ID: 0648615203 Enrollment ID: I20240311001691 |
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