DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: EAGAN COUNSELING CLINIC

MEDICARE: EAGAN COUNSELING CLINIC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251B00000XCase Management Agency800689-2-MHCMN
2103TP2701XGroup Psychotherapy Psychologist800689-2-MHCMN
3103TC0700XClinical Psychologist800689-2-MHCMN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1800084OTHERMNPREFERRED ONE
259280EAOTHERMNBCBS
300892OTHERMNHEALTH PARTNERS
4101973OTHERMNUCARE
584-57408OTHERMNMEDICA

General Provider Information

NPI Number : 1144311184
Entity Type Code : Organization
Provider Name (Legal Business Name) : EAGAN COUNSELING CLINIC
Provider Business Mailing Address
First Line : 3450 OLEARY LN
Second Line :
City : EAGAN
State : MN
Zip : 55123-2340
Country : US
Telephone Number : 651-454-0114
Fax Number : 651-454-3492
Provider Business Practice Location Address
First Line : 3450 OLEARY LN
Second Line :
City : EAGAN
State : MN
Zip : 55123-2340
Country : US
Telephone Number : 651-454-0114
Fax Number : 651-454-3492
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : PEGGY DOMINIC
Credential :
Telephone Number : 651-365-8217
Provider Enumeration Date : 09/27/2006
Last Update Date : 04/10/2008

Similar Medicare Providers

1184200065 — DR. EMMANUELLE HANSEN PSYD
Practice Location Address:
3450 OLEARY LN
EAGAN, MN
55123-2340
Practice Phone: 651-454-0114
Practice Fax:
1750366167 — MS. PATRICE LAUER-ROBERTS LICSW
Practice Location Address:
3450 OLEARY LN
EAGAN, MN
55123-2340
Practice Phone: 651-454-0114
Practice Fax: 651-454-3492
1457379026 — DR. RICHARD EDWIN CLOSE DMIN, MA,LICSW, LMFT
Practice Location Address:
3450 OLEARY LN
EAGAN, MN
55123-2340
Practice Phone: 651-454-0114
Practice Fax: 651-454-3492
1508968355 — ST PAUL EYE CLINIC PA
Practice Location Address:
3440 OLEARY LN
EAGAN, MN
55123-2340
Practice Phone: 651-454-3839
Practice Fax: 651-994-8867
1700987070 — DR. RICHARD JOSEPH VENJOHN PHD, LP
Practice Location Address:
3450 OLEARY LN
EAGAN, MN
55123-2340
Practice Phone: 651-454-0114
Practice Fax: 651-454-3492
1831290543 — MRS. BRITT ERIKA NYSTROMBALFE LICSW
Practice Location Address:
3450 OLEARY LN
EAGAN, MN
55123-2340
Practice Phone: 651-454-0114
Practice Fax: 651-454-3492

Directions to “EAGAN COUNSELING CLINIC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.