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General NPI Number Information
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NPI Number | 1346850518
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Entity Type | Organization
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Legal Business Name | STACEY KLEMPNAUER MSW, LICSW INC
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Dates
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Enumeration Date | 08/03/2020
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Last Update Date | 08/03/2020
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Provider Practice Location Address
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Address Line | 402 WASHINGTON ST
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City | NORTHFIELD
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State | MN
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Zip | 55057-5190
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Country | US
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Telephone | 507-645-0444
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Fax |
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Provider Business Mailing Address
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Address Line | 1904 MICHIGAN DR
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City | NORTHFIELD
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State | MN
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Zip | 55057-4834
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Country | US
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Telephone | 507-645-0444
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | STACEY LEIGH KLEMPNAUER
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Credential | MSW, LICSW
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Telephone | 507-645-0444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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