Van Fossen, Marcy
Van Fossen, Marcy is an sole proprietor health care provider with primary practice located at 66 E 3Rd St 201, Winona MN 55987-3478. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Van Fossen, Marcy can be contacted via phone (507) 452-7292.Contact Information
Primary practice address
66 E 3Rd St 201
Winona MN 55987-3478
Phone: (507) 452-7292
Fax: (507) 457-9887
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | LP4392 | Minnesota |
Profile Details
| NPI number | 1255483491 |
|---|---|
| LBN Legal business name | Van Fossen, Marcy |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 17th, 2007 |
| Last updated | Oct 16th, 2007 - about 18 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 | 1255483491 | NPPES |
| Minnesota | Other | 975T1VA | BCBS-MN |
| Minnesota | MEDICAID | 135853 | BCBS-MN |
| Minnesota | Other | 731291045880 | BCBS-MN |
| Minnesota | Other | HP55644 | BCBS-MN |
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