Healthcare Provider Details

I. General information

NPI: 1275866253
Provider Name (Legal Business Name): ROSS ALLEN AALGAARD DSW, LICSW, LADC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2009
Last Update Date: 09/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 S FRONT ST STE 5A
MANKATO MN
56001-3887
US

IV. Provider business mailing address

PO BOX 253
MANKATO MN
56002-0253
US

V. Phone/Fax

Practice location:
  • Phone: 507-400-2900
  • Fax:
Mailing address:
  • Phone: 507-400-2900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number305091
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number19830
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: