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Individual

AUTUMN MARIE JARVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
502 E 2ND ST, DULUTH, MN 55805-1913
(218) 786-8376
Mailing address
10408 US HIGHWAY 151, MANITOWOC, WI 54220-9775
(715) 410-3433

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
13129-121
WI
1041C0700X
Clinical Social Worker
0904020149
VA
1041C0700X
Clinical Social Worker
090420149
VA
1041C0700X
Clinical Social Worker
Primary
31486
MN
1041C0700X
Clinical Social Worker
6801117151
MI
1041C0700X
Clinical Social Worker
9823
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6801117151
1041C0700X
MI
01
9823
LICENSE
WI
01
9823-123
LICENSE
WI
Enumeration date
03/24/2021
Last updated
05/04/2026
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