| Pinecone Family Counseling, Pa | |
|
2385 Troop Dr. Suite 202 Sartell MN 56377 | |
| (320) 253-2385 | |
| (320) 253-2386 |
| Full Name | Pinecone Family Counseling, Pa |
|---|---|
| Speciality | Psychologist |
| Location | 2385 Troop Dr., Sartell, Minnesota |
| Authorized Official Name and Position | Dorothy Therese Soukup (PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 3202532385 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pinecone Family Counseling, Pa 2385 Troop Dr. Suite 202 Sartell MN 56377 Ph: (320) 253-2385 | Pinecone Family Counseling, Pa 2385 Troop Dr. Suite 202 Sartell MN 56377 Ph: (320) 253-2385 |
| NPI Number | 1104094457 |
|---|---|
| Provider Enumeration Date | 02/20/2008 |
| Last Update Date | 09/08/2017 |
| Medicare PECOS PAC ID | 6406931005 |
|---|---|
| Medicare Enrollment ID | O20080306000456 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104094457 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | LP3278 (Minnesota) | Primary |
| Provider Name | Dorothy T Soukup |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497846950 PECOS PAC ID: 4981654316 Enrollment ID: I20050124001027 |
| Provider Name | James Rudolph Tuorila |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710992243 PECOS PAC ID: 7012174923 Enrollment ID: I20120204000043 |
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