| Dr Jeanine E Kotschwar, PHD | |
|
2100 S Columbia Rd, Suite 202, Grand Forks, ND 58201-5895 | |
| (701) 772-1588 | |
| (701) 746-6077 |
| Full Name | Dr Jeanine E Kotschwar |
|---|---|
| Gender | Female |
| Speciality | Psychologist - Clinical |
| Location | 2100 S Columbia Rd, Grand Forks, North Dakota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083630974 | NPI | - | NPPES |
| 197M7K0 | Other | MN | MN BLUE CROSS |
| 366850900 | Medicaid | MN | |
| KOT22727 | Other | ND | ND BLUE CROSS |
| 16917 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 177 (North Dakota) | Primary |
| Entity Name | Practice Place Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184283541 PECOS PAC ID: 2860721164 Enrollment ID: O20190911003931 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jeanine E Kotschwar, PHD 2100 S Columbia Rd, Suite 202, Grand Forks, ND 58201-5895 Ph: (701) 772-1588 | Dr Jeanine E Kotschwar, PHD 2100 S Columbia Rd, Suite 202, Grand Forks, ND 58201-5895 Ph: (701) 772-1588 |
Dr. Kara Brita Wettersten, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2100 S Columbia Rd, Suite 202, Grand Forks, ND 58201 Phone: 701-772-1588 Fax: 701-746-6077 | |
Ms. Leslie A Rowan, PH.D. Psychologist Medicare: Medicare Enrolled Practice Location: 2100 South Columbia Road, Suite 202, Grand Forks, ND 58201 Phone: 701-772-1588 Fax: 701-746-6077 | |
Dr. Jonathan E Whalen, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 2808 17th Ave S, Grand Forks, ND 58201 Phone: 701-746-8376 Fax: 701-746-9872 | |
Dr. Sue Ann Russell, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 2704 Belmont Rd, Grand Forks, ND 58201 Phone: 701-746-8737 Fax: 701-746-4763 | |
Dr. Kyle Patrick De Young, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2100 S Columbia Rd, Suite 202, Grand Forks, ND 58201 Phone: 701-772-1588 | |
Elizabeth J Luger, PHD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 3535 S 31st St Ste 201, Grand Forks, ND 58201 Phone: 701-780-6821 Fax: 701-780-1973 |