| Kelsey Landis, Ms Lmft Llc | |
|
2351 Connecticut Ave S Ste 105 Sartell MN 56377-2479 | |
| (320) 316-0288 | |
| Not Available |
| Full Name | Kelsey Landis, Ms Lmft Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2351 Connecticut Ave S Ste 105, Sartell, Minnesota |
| Authorized Official Name and Position | Kelsey Landis (OWNER) |
| Authorized Official Contact | 3204921414 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelsey Landis, Ms Lmft Llc 2351 Connecticut Ave S Ste 105 Sartell MN 56377-2479 Ph: (320) 316-0288 | Kelsey Landis, Ms Lmft Llc 2351 Connecticut Ave S Ste 105 Sartell MN 56377-2479 Ph: (320) 316-0288 |
| NPI Number | 1528572021 |
|---|---|
| Provider Enumeration Date | 11/21/2017 |
| Last Update Date | 11/21/2017 |
| Medicare PECOS PAC ID | 7810429438 |
|---|---|
| Medicare Enrollment ID | O20241021000506 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528572021 | NPI | - | NPPES |
| 273940100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 1742 (Minnesota) | Primary |
| Provider Name | Kelsey Ann Landis |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1104152032 PECOS PAC ID: 8729510342 Enrollment ID: I20241021000700 |
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