Wholehearted Healing Llc | |
6381 Osgood Ave N Bldg C Stillwater MN 55082-6118 | |
(507) 403-8190 | |
(651) 383-4544 |
Full Name | Wholehearted Healing Llc |
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Speciality | Counselor |
Location | 6381 Osgood Ave N Bldg C, Stillwater, Minnesota |
Authorized Official Name and Position | Stephanie Summer Kalliman (CLINICAL DIRECTOR AND LMFT) |
Authorized Official Contact | 5074038190 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Wholehearted Healing Llc 6381 Osgood Ave N Bldg C Stillwater MN 55082-6118 Ph: (507) 403-8190 | Wholehearted Healing Llc 6381 Osgood Ave N Bldg C Stillwater MN 55082-6118 Ph: (507) 403-8190 |
NPI Number | 1255934196 |
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Provider Enumeration Date | 11/20/2020 |
Last Update Date | 11/20/2020 |
Certification Date | 11/19/2020 |
Medicare PECOS PAC ID | 8123543154 |
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Medicare Enrollment ID | O20250422002820 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255934196 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Provider Name | Michael Albert Weitekamp |
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Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1326644352 PECOS PAC ID: 2466978309 Enrollment ID: I20250424000394 |
Provider Name | Elizabeth Mcmillen Campbell |
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Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1003684036 PECOS PAC ID: 6901322189 Enrollment ID: I20250430002598 |
Provider Name | Amber Nicole Egdorf |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1780120378 PECOS PAC ID: 7416473517 Enrollment ID: I20250501002275 |
Provider Name | Blake A Bender |
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Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1639848088 PECOS PAC ID: 8628595683 Enrollment ID: I20250505000791 |
Provider Name | Eden Broberg |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1265190474 PECOS PAC ID: 7315465325 Enrollment ID: I20250514000681 |
Provider Name | Carley Tolman Saravia |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1578338745 PECOS PAC ID: 1355869389 Enrollment ID: I20250514000873 |
Provider Name | Hannah Blaha |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1295404325 PECOS PAC ID: 7719406230 Enrollment ID: I20250528000720 |
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