Ingersol, Mina
Ingersol, Mina is an sole proprietor health care provider with primary practice located at 5522 W Bald Eagle Blvd , White Bear Lake MN 55110-6412. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Ingersol, Mina can be contacted via phone (651) 429-0838.Contact Information
Primary practice address
5522 W Bald Eagle Blvd
White Bear Lake MN 55110-6412
Phone: (651) 429-0838
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 01313 | Minnesota |
Profile Details
| NPI number | 1306959416 |
|---|---|
| LBN Legal business name | Ingersol, Mina |
| Credentials | LICSW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 16th, 2006 |
| Last updated | Jun 10th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306959416 | NPPES |
| Minnesota | MEDICAID | 220058900 | |
| Minnesota | Other | 56088DR |
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