Individual
JAN BIRCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
112 1ST ST W, BEMIDJI, MN 56601-4002
(218) 888-8032
(218) 888-8033
Mailing address
1900 SILVER LAKE RD NW STE 110, NEW BRIGHTON, MN 55112-1789
(651) 628-9566
(651) 628-0411
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2025004398
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000
—
MO
Enumeration date
12/16/2022
Last updated
03/27/2026
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