Healthcare Provider Details

I. General information

NPI: 1316809890
Provider Name (Legal Business Name): ASHLEY OSIO MSW, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5891 CEDAR LAKE RD S STE 4
ST LOUIS PARK MN
55416-1460
US

IV. Provider business mailing address

23115 SUMMIT AVE
EXCELSIOR MN
55331-8960
US

V. Phone/Fax

Practice location:
  • Phone: 612-814-1485
  • Fax:
Mailing address:
  • Phone: 612-404-4424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number20092
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: