Individual
JAN SEARCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
2304A MOUNT VIEW AVE, MINNEAPOLIS, MN 55405-1960
(612) 849-5059
Mailing address
2304A MOUNT VIEW AVE, MINNEAPOLIS, MN 55405-1960
(612) 849-5059
(612) 465-1580
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2586
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202561815
FEDERAL TAX ID
MN
01
—
7696210
MINNESOTA TAX ID
MN
01
—
7G348SE
BCBS PAYEE ID
MN
Enumeration date
10/09/2006
Last updated
03/15/2022
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