Healthcare Provider Details

I. General information

NPI: 1245141753
Provider Name (Legal Business Name): EVELYN MORALES MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 CENTRAL AVE NE
MINNEAPOLIS MN
55418-3709
US

IV. Provider business mailing address

2301 CENTRAL AVE NE
MINNEAPOLIS MN
55418-3709
US

V. Phone/Fax

Practice location:
  • Phone: 612-588-9411
  • Fax: 612-522-6627
Mailing address:
  • Phone: 612-588-9411
  • Fax: 612-522-6627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number35850
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: