| Stacey S Haugen, Pllc | |
|
6221 University Drive Bismarck ND 58504 | |
| (701) 258-4483 | |
| (701) 258-4483 |
| Full Name | Stacey S Haugen, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 6221 University Drive, Bismarck, North Dakota |
| Authorized Official Name and Position | Stacey S Haugen (PRESIDENT) |
| Authorized Official Contact | 7012584483 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stacey S Haugen, Pllc 6221 University Drive Bismarck ND 58504 Ph: (701) 258-4483 | Stacey S Haugen, Pllc 6221 University Drive Bismarck ND 58504 Ph: (701) 258-4483 |
| NPI Number | 1902262520 |
|---|---|
| Provider Enumeration Date | 01/12/2016 |
| Last Update Date | 01/12/2016 |
| Medicare PECOS PAC ID | 4789988965 |
|---|---|
| Medicare Enrollment ID | O20160209000829 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902262520 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (North Dakota) | Primary |
| Provider Name | Stacey S Haugen |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1255436226 PECOS PAC ID: 8123122447 Enrollment ID: I20070327000135 |
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