Healthcare Provider Details

I. General information

NPI: 1740914050
Provider Name (Legal Business Name): HANNAH LOUISE BARNES MSW, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2022
Last Update Date: 02/08/2024
Certification Date: 02/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 RIVER RD
GRAND RAPIDS MN
55744-4048
US

IV. Provider business mailing address

118 NE 11TH AVE
GRAND RAPIDS MN
55744-3286
US

V. Phone/Fax

Practice location:
  • Phone: 182-322-4103
  • Fax:
Mailing address:
  • Phone: 218-256-7079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number29361
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: