Lisa Anne Eskola, MA, LMFT
Individual provider Active NPI Marriage & Family Therapist · Otsego, MN
NPI 1104842459 · NPPES record last updated Apr 23, 2018
Key facts
- NPI
- 1104842459
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 1551 (MN)
- Practice address
- 9245 Quantrelle Ave NE
Otsego, MN 55330-0168 - Phone
- (763) 746-9492
- Fax
- (763) 746-3685
- NPI assigned
- Jul 13, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Marriage and Family Therapist
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Nystrom and Associates LTD
Practice addresses (Care Compare)
9245 Quantrelle Ave NE
Otsego, MN 55330-0168
Phone (763) 746-9492
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231227003102 | MN | Practitioner - Marriage and Family Therapist | 9234589631 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1551 | MN | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Support Services Inc. | Current |
Accepting new patients | |
| Nystrom & Associates, LTD | Marriage & Family Therapist | Current |
Accepting new patients |
Locations
7300 147th St W
Ste 600
Apple Valley, MN 55124
Phone (952) 997-3020
207 Jefferson Blvd
Big Lake, MN 55309
Phone (763) 367-6080
332 W Superior St
Ste 300
Duluth, MN 55802
Phone (218) 481-9408
9245 Quantrelle Ave NE
Otsego, MN 55330
Phone (763) 308-8619
1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 1551 | MN | Yes |
Addresses
Primary practice location
9245 Quantrelle Ave NE
Otsego, MN 55330-0168
Mailing address
1900 Silver Lake Rd NW
Suite 110
New Brighton, MN 55112-1786
Phone (651) 628-9566
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 876115900 | Medicaid | MN |
Other names
- Lisa Anne Clutz
Other providers in Otsego, MN
- David R. Edwards
- Lynda Ellen Eklund
- Jordan Enevold
- Charissa Erickson
- John William Eskola
- Jennifer Lynn Esselman
- Evans Park, Inc
- Peter Moises Falcon
- Favor Homecare LLC
- Amy Fiske
All providers in Otsego, MN · Marriage & Family Therapist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.