Healthcare Provider Details

I. General information

NPI: 1922520998
Provider Name (Legal Business Name): ERIC JOHN SPAGENSKI MSW, LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ERIC SPAGENSKI MSW, LICSW

II. Dates (important events)

Enumeration Date: 07/12/2017
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 1ST ST SW
ROCHESTER MN
55905-2666
US

IV. Provider business mailing address

200 1ST ST SW
ROCHESTER MN
55905-0002
US

V. Phone/Fax

Practice location:
  • Phone: 507-293-5187
  • Fax: 507-538-6622
Mailing address:
  • Phone: 507-284-2131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number21918
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number21918
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: