Mr Lars Olson, MS | |
1650 Madison Ave Ste 102, Mankato, MN 56001-5471 | |
(507) 345-7012 | |
(507) 388-6937 |
Full Name | Mr Lars Olson |
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Gender | Male |
Speciality | Psychologist - Clinical |
Location | 1650 Madison Ave Ste 102, Mankato, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1568086536 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103TC0700X | Psychologist - Clinical | 000.6645 (Colorado) | Primary |
Entity Name | Therapy Collective, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1487485843 PECOS PAC ID: 3971043464 Enrollment ID: O20240911001735 |
Mailing Address | Practice Location Address |
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Mr Lars Olson, MS 940 County Road 336, Ignacio, CO 81137-9606 Ph: (307) 254-1196 | Mr Lars Olson, MS 1650 Madison Ave Ste 102, Mankato, MN 56001-5471 Ph: (507) 345-7012 |
Elizabeth Ann Quinby, M.A. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1028 Woodland Ave, Mankato, MN 56001 Phone: 319-493-8773 | |
Ms. Janice Mary Boyum, MSLP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 710 South 2nd St., Mankato, MN 56001 Phone: 507-625-7660 Fax: 507-625-8998 | |
Dr. Theodore Surdy, PHD LP Psychologist Medicare: Accepting Medicare Assignments Practice Location: 1227 Caledonia St, Mankato, MN 56001 Phone: 507-388-8874 Fax: 507-685-4807 | |
Dr. Kimberly Ann Haala, PH.D., L.P. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 1025 Marsh St, Mankato, MN 56001 Phone: 507-625-4031 | |
Dr. Nancy Fenrick, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 600 Reed St, Suite 115, Mankato, MN 56001 Phone: 507-625-4060 Fax: 507-625-3915 | |
Matthew John Conetta, PSY.D., L.P. Psychologist Medicare: Medicare Enrolled Practice Location: 1400 Madison Ave Ste 352, Mankato, MN 56001 Phone: 507-625-1811 Fax: 507-387-7785 | |
Rosean Bishop, PHD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 1025 Marsh St, Mankato, MN 56001 Phone: 507-625-4031 |