| Regroup Counseling And Consulting Psc | |
|
18336 Joplin St Nw Elk River MN 55330-1773 | |
| (763) 350-9687 | |
| (651) 447-5394 |
| Full Name | Regroup Counseling And Consulting Psc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 18336 Joplin St Nw, Elk River, Minnesota |
| Authorized Official Name and Position | Tia M Dvorak (OWNER THERAPIST) |
| Authorized Official Contact | 7633509687 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Regroup Counseling And Consulting Psc 18336 Joplin St Nw Elk River MN 55330-1773 Ph: (763) 350-9687 | Regroup Counseling And Consulting Psc 18336 Joplin St Nw Elk River MN 55330-1773 Ph: (763) 350-9687 |
| NPI Number | 1194298026 |
|---|---|
| Provider Enumeration Date | 01/03/2019 |
| Last Update Date | 04/03/2024 |
| Certification Date | 04/03/2024 |
| Medicare PECOS PAC ID | 0648689042 |
|---|---|
| Medicare Enrollment ID | O20210517000423 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194298026 | NPI | - | NPPES |
| 1194298026 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | April Ann Hegdahl |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720597487 PECOS PAC ID: 4789932823 Enrollment ID: I20180806001127 |
| Provider Name | Denae Reanne Kuenzel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033446331 PECOS PAC ID: 2860520129 Enrollment ID: I20200227002723 |
| Provider Name | Chelsey R Paulson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891308813 PECOS PAC ID: 6305250317 Enrollment ID: I20210203001769 |
| Provider Name | Sarah Hamlin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033873047 PECOS PAC ID: 1759773807 Enrollment ID: I20220121001490 |
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