Healthcare Provider Details

I. General information

NPI: 1760106322
Provider Name (Legal Business Name): SAMANTHA A ARNESON MSW, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SAMANTHA A ANDERSON

II. Dates (important events)

Enumeration Date: 09/28/2022
Last Update Date: 09/28/2022
Certification Date: 09/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 EAST 1ST STREET
DULUTH MN
55805-2407
US

IV. Provider business mailing address

1401 EAST 1ST STREET
DULUTH MN
55805-2407
US

V. Phone/Fax

Practice location:
  • Phone: 218-728-4491
  • Fax: 218-302-8698
Mailing address:
  • Phone: 218-728-4491
  • Fax: 218-302-8698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number28961
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: