Organization
SHARON GROSTEPHAN, LICSW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHARON GROSTEPHAN LICSW (LICENSED SOCIAL WORKER)
(763) 441-9712
Entity
Organization
Contact information
Practice address
1660 S HIGHWAY 100, SUITE 428, ST LOUIS PARK, MN 55416-1533
(612) 597-6585
Mailing address
1660 S HIGHWAY 100, SUITE 428, ST LOUIS PARK, MN 55416-1533
(612) 597-6585
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LICSW 841
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
834358600
—
MN
Enumeration date
01/03/2007
Last updated
04/29/2019
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