Suzanne Carol Beveroth Pollack | Stillwater, MN • PECOS Search

Suzanne Carol Beveroth Pollack

Counselor

Behavioral Health & Social Service Providers

14949 62nd St N, Stillwater, MN 55082-6132

PECOS Enrollment

Based on the most recent information from CMS, provider Suzanne Carol Beveroth Pollack does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1861047383
Provider Type
Individual
Full Name
Beveroth Pollack, Suzanne Carol
Credential
LISW

Gender
Female
Sole Proprietor
No
Enumeration Date
8/2/2019
Last Updated
8/2/2019

Contact Information

Practice Location

14949 62nd St N, Stillwater, MN 55082-6132

(651) 275-7401

Mailing Location

PO Box 30, Stillwater, MN 55082-0030

(651) 275-7401

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License 7619 Minnesota