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NPI Code Detail

MEDICARE: MERICA JOY OVERCASH-THOM LMFT

MEDICARE: MERICA JOY OVERCASH-THOM LMFT
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
1221700000XArt Therapist21-467MN
2106H00000XMarriage & Family Therapist4259MN

General Provider Information

NPI Number : 1114679032
Entity Type Code : Individual
Provider Name (Legal Business Name) : MERICA JOY OVERCASH-THOM LMFT
Provider Business Mailing Address
First Line : 275 4TH ST E STE 301
Second Line :
City : SAINT PAUL
State : MN
Zip : 55101-1771
Country : US
Telephone Number : 651-318-0109
Fax Number :
Provider Business Practice Location Address
First Line : 275 4TH ST E STE 301
Second Line :
City : SAINT PAUL
State : MN
Zip : 55101-1771
Country : US
Telephone Number : 651-318-0109
Fax Number : 651-344-0515
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2022
Last Update Date : 02/07/2022

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Directions to “ MERICA JOY OVERCASH-THOM LMFT” Practice Location

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