| Tapestry Psychotherapy Group, Llc | |
|
230 W Superior St Ste 400 Duluth MN 55802-4021 | |
| (218) 208-3647 | |
| (218) 212-9933 |
| Full Name | Tapestry Psychotherapy Group, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 230 W Superior St Ste 400, Duluth, Minnesota |
| Authorized Official Name and Position | Susan Dolph (OWNER) |
| Authorized Official Contact | 2182083647 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tapestry Psychotherapy Group, Llc 230 W Superior St Ste 400 Duluth MN 55802-4021 Ph: (218) 208-3647 | Tapestry Psychotherapy Group, Llc 230 W Superior St Ste 400 Duluth MN 55802-4021 Ph: (218) 208-3647 |
| NPI Number | 1184216657 |
|---|---|
| Provider Enumeration Date | 02/06/2021 |
| Last Update Date | 02/06/2021 |
| Certification Date | 02/06/2021 |
| Medicare PECOS PAC ID | 8628587631 |
|---|---|
| Medicare Enrollment ID | O20250602001950 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184216657 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Susan M Dolph |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063065019 PECOS PAC ID: 9537678545 Enrollment ID: I20250602002079 |
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