| North Psychology Clinic Pa | |
|
11165 Zealand Ave N Champlin MN 55316-3595 | |
| (763) 531-0566 | |
| (763) 531-0602 |
| Full Name | North Psychology Clinic Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 11165 Zealand Ave N, Champlin, Minnesota |
| Authorized Official Name and Position | Diane K. Felton (PRESIDENT) |
| Authorized Official Contact | 7635310566 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Psychology Clinic Pa 11165 Zealand Ave N Champlin MN 55316-3595 Ph: (763) 531-0566 | North Psychology Clinic Pa 11165 Zealand Ave N Champlin MN 55316-3595 Ph: (763) 531-0566 |
| NPI Number | 1265462212 |
|---|---|
| Provider Enumeration Date | 07/04/2006 |
| Last Update Date | 02/13/2025 |
| Certification Date | 02/13/2025 |
| Medicare PECOS PAC ID | 3870545668 |
|---|---|
| Medicare Enrollment ID | O20050221000501 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265462212 | NPI | - | NPPES |
| 973518600 | Medicaid | MN | |
| 30787NO | Other | MN | BLUE CROSS BLUE SHIELD |
| 30786NO | Other | MN | BLUE CROSS BLUE SHIEL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (Minnesota) | Primary |
| Provider Name | Thomas A Breitenbucher |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699846154 PECOS PAC ID: 9638350465 Enrollment ID: I20110225000638 |
| Provider Name | Devon Elizabeth Whitehead |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003037458 PECOS PAC ID: 9335387216 Enrollment ID: I20130606000524 |
| Provider Name | Michelle R Mandell-paulson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912425158 PECOS PAC ID: 6608268677 Enrollment ID: I20220125001495 |
| Provider Name | Morgan Bobo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629600010 PECOS PAC ID: 4183169550 Enrollment ID: I20240710000158 |
| Provider Name | Kirsten Elizabeth Jankovich |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1679536973 PECOS PAC ID: 9234438185 Enrollment ID: I20250306001388 |
Harman Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11241 Mississippi Dr N, Champlin, MN 55316 Phone: 612-532-6404 | |
Riverview Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11326 Maplewood Ln N, Champlin, MN 55316 Phone: 763-528-5235 Fax: 763-424-7288 | |
Thrive To Wellness Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9816 129th Ln N, Champlin, MN 55316 Phone: 612-210-4481 | |
Invictus Psychotherapy Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11181 Hillsboro Ave N, Champlin, MN 55316 Phone: 612-481-4049 | |
Beacon Therapy Associates, Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 11141 Zealand Ave N, Champlin, MN 55316 Phone: 763-951-3091 Fax: 763-951-3097 | |
Agape Psychiatric Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10913 131st Ave N, Champlin, MN 55316 Phone: 610-202-6770 |