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NPI Code Detail

MEDICARE: CANVAS HEALTH, INC.

MEDICARE: CANVAS HEALTH, INC.
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
1101YM0800XMental Health CounselorMN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
156706HUOTHERMNBLUE CROSS BLUE SHIELD
2313930OTHERMNVALUE OPTIONS
38461062OTHERMNUNITED BEHAVIORAL HEALTH
4106221OTHERMNPMAP U-CARE
51029858OTHERMNPREFERRED ONE
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1922051325
Entity Type Code : Organization
Provider Name (Legal Business Name) : CANVAS HEALTH, INC.
Provider Business Mailing Address
First Line : 7066 STILLWATER BLVD N
Second Line :
City : OAKDALE
State : MN
Zip : 55128-3937
Country : US
Telephone Number : 651-777-5222
Fax Number : 651-251-5111
Provider Business Practice Location Address
First Line : 7066 STILLWATER BLVD N
Second Line :
City : OAKDALE
State : MN
Zip : 55128-3937
Country : US
Telephone Number : 651-777-5222
Fax Number : 651-251-5111
Authorized Official
Title or Position : COO
Name : KHU THAO
Credential : MSW, PSYD, LICSW, LP
Telephone Number : 651-251-5042
Provider Enumeration Date : 05/18/2006
Last Update Date : 12/27/2023

Similar Medicare Providers

1558136416 — KENDRA J SHULMAN MSW, LICSW
Practice Location Address:
7066 STILLWATER BLVD N
OAKDALE, MN
55128-3937
Practice Phone: 612-364-4900
Practice Fax:
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OAKDALE, MN
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1164350666 — MIKAELA ERICKSON LPCC
Practice Location Address:
7066 STILLWATER BLVD N
OAKDALE, MN
55128-3937
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Practice Fax:
1114990066 — GLORIA F CANTOR APRN CNS
Practice Location Address:
7066 STILLWATER BLVD N
OAKDALE, MN
55128-3937
Practice Phone: 651-777-5222
Practice Fax: 651-251-5111
1598793804 — DR. JOHN BREWER GLASS M.D.
Practice Location Address:
7066 STILLWATER BLVD N
OAKDALE, MN
55128-3937
Practice Phone: 651-777-5222
Practice Fax: 651-251-5111
1215967815 — MR. JOHN SCHIPKE LICSW
Practice Location Address:
7066 STILLWATER BLVD N
OAKDALE, MN
55128-3937
Practice Phone: 651-777-5222
Practice Fax: 651-251-5111

Directions to “CANVAS HEALTH, INC. ” Practice Location

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