Healthcare Provider Details

I. General information

NPI: 1538265210
Provider Name (Legal Business Name): JAIME LEA MONSON MSW, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9220 BASS LAKE RD STE 255
NEW HOPE MN
55428-3019
US

IV. Provider business mailing address

9220 BASS LAKE RD STE 255
NEW HOPE MN
55428-3019
US

V. Phone/Fax

Practice location:
  • Phone: 763-252-4509
  • Fax: 888-965-5130
Mailing address:
  • Phone: 763-252-4509
  • Fax: 888-965-5130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16018
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: