Individual
MARY LOU JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSSW, LICSW
Contact information
Practice address
610 FLORENCE AVE, OWATONNA, MN 55060-4704
(507) 451-2630
(507) 455-8133
Mailing address
610 FLORENCE AVE, OWATONNA, MN 55060-4704
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8206
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
074027600
—
MN
01
—
118039
UCARE
MN
01
—
4G504WA
BLUE CROSS BLUE SHIELD
MN
01
—
62-20365
UNITED BEHAVIORAL HEALTH
MN
01
—
HP20016
HEALTH PARTNERS
MN
Enumeration date
10/12/2006
Last updated
02/10/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us