Healthcare Provider Details

I. General information

NPI: 1306656939
Provider Name (Legal Business Name): ALEXIS ZOTTI LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 E SUPERIOR ST STE 561
DULUTH MN
55802-2091
US

IV. Provider business mailing address

105 2ND AVE NE STE 110
GLENWOOD MN
56334-1226
US

V. Phone/Fax

Practice location:
  • Phone: 320-428-0744
  • Fax:
Mailing address:
  • Phone: 320-428-0744
  • Fax: 320-438-2829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number31690
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: