Individual
KENT NOLAN SWENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
1821 UNIVERSITY AVENUE WEST, N464, ST PAUL, MN 55104
(651) 659-2900
Mailing address
2372 COMO AVENUE, ST PAUL, MN 55108
(651) 999-4648
(651) 645-7307
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6926
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
327S7SW
BLUE CROSS BLUE SHIELD
MN
05
—
4S28S8100
—
MN
01
—
6247383
UBH
MN
Enumeration date
12/06/2006
Last updated
01/30/2018
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