MEDICARE: CARLEE STAPLES LGSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	33466	MN

General Provider Information

NPI Number	:	1831057355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLEE STAPLES LGSW

Provider Business Mailing Address
First Line	:	1015 SNELLING AVE S
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55116-2447
Country	:	US
Telephone Number	:	651-389-2460
Fax Number	:

Provider Business Practice Location Address
First Line	:	1015 SNELLING AVE S
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55116-2447
Country	:	US
Telephone Number	:	651-389-2460
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/13/2026

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Directions to “ CARLEE STAPLES LGSW” Practice Location

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