Healthcare Provider Details

I. General information

NPI: 1902625205
Provider Name (Legal Business Name): LGC SERVICES QUALITY CASE MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2024
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 1ST AVE NE STE 1
AUSTIN MN
55912-3401
US

IV. Provider business mailing address

102 1ST AVE NE STE 1
AUSTIN MN
55912-3401
US

V. Phone/Fax

Practice location:
  • Phone: 507-396-2162
  • Fax:
Mailing address:
  • Phone: 507-396-2162
  • Fax: 507-396-2411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JESSIE LEA MEYER
Title or Position: CO-OWNER/CLINICAL DIRECTOR
Credential: LICSW
Phone: 507-396-2162