Provider Demographics
NPI:1669494605
Name:MIDWEST EAP SOLUTIONS
Entity Type:Organization
Organization Name:MIDWEST EAP SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BRENNY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-253-1909
Mailing Address - Street 1:1010 W SAINT GERMAIN ST STE 580
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301-4166
Mailing Address - Country:US
Mailing Address - Phone:320-253-1909
Mailing Address - Fax:320-240-1501
Practice Address - Street 1:1010 W SAINT GERMAIN ST STE 580
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-4166
Practice Address - Country:US
Practice Address - Phone:320-253-1909
Practice Address - Fax:320-240-1501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN47103MIOtherBLUE CROSS BLUE SHIELD
MN47103MIOtherBLUE CROSS BLUE SHIELD