Healthcare Provider Details

I. General information

NPI: 1053231696
Provider Name (Legal Business Name): CHELSY SWANSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 PARK GLEN RD STE 155
SAINT LOUIS PARK MN
55416-4888
US

IV. Provider business mailing address

4500 PARK GLEN RD STE 155
SAINT LOUIS PARK MN
55416-4888
US

V. Phone/Fax

Practice location:
  • Phone: 612-284-4291
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number32219
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: