| Stepping Stone Clinic, Llc | |
|
6625 Lyndale Ave S Suite 500 Richfield MN 55423-2373 | |
| (612) 886-3704 | |
| (612) 886-3681 |
| Full Name | Stepping Stone Clinic, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6625 Lyndale Ave S, Richfield, Minnesota |
| Authorized Official Name and Position | Rachelle Hansen (CLINICAL DIRECTOR) |
| Authorized Official Contact | 7017417830 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stepping Stone Clinic, Llc 5637 Colfax Ave S Minneapolis MN 55419-1747 Ph: (701) 741-7830 | Stepping Stone Clinic, Llc 6625 Lyndale Ave S Suite 500 Richfield MN 55423-2373 Ph: (612) 886-3704 |
| NPI Number | 1720526759 |
|---|---|
| Provider Enumeration Date | 02/09/2017 |
| Last Update Date | 02/09/2017 |
| Medicare PECOS PAC ID | 1951675321 |
|---|---|
| Medicare Enrollment ID | O20170922003441 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720526759 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | CORP00418 (Minnesota) | Primary |
| Provider Name | Deborah E Fisher |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1134299167 PECOS PAC ID: 9739217282 Enrollment ID: I20100504000902 |
| Provider Name | Rachelle E Hansen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487023826 PECOS PAC ID: 5890004725 Enrollment ID: I20151015002461 |
| Provider Name | Andrew K Scarbrough |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407366016 PECOS PAC ID: 2365704962 Enrollment ID: I20180320000030 |
| Provider Name | Jan M Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144864596 PECOS PAC ID: 8628404589 Enrollment ID: I20200212002487 |
| Provider Name | Renee T Vonweiss |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265427629 PECOS PAC ID: 8426486754 Enrollment ID: I20200319000600 |
| Provider Name | Christi Bostwick |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1811139785 PECOS PAC ID: 7113347550 Enrollment ID: I20201023000792 |
| Provider Name | Barbara Gina Chrysler |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1568050623 PECOS PAC ID: 0244631646 Enrollment ID: I20210623000654 |
| Provider Name | Erin Keto-sherman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891470068 PECOS PAC ID: 4981058393 Enrollment ID: I20231003002252 |
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