MEDICARE: DEBRA JEAN WAITE LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	2163	MN

General Provider Information

NPI Number	:	1023084480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBRA JEAN WAITE LICSW

Provider Business Mailing Address
First Line	:	8100 34TH AVE S
Second Line	:	21110Q
City	:	BLOOMINGTON
State	:	MN
Zip	:	55425-1672
Country	:	US
Telephone Number	:	952-883-7961
Fax Number	:	952-883-5395

Provider Business Practice Location Address
First Line	:	5100 GAMBLE DR
Second Line	:	SUITE 100 MAIL STOP 31200A
City	:	SAINT LOUIS PARK
State	:	MN
Zip	:	55416-1521
Country	:	US
Telephone Number	:	952-593-8777
Fax Number	:	952-595-6408

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1851364392 — DR. JULIE A CHAVEZ DDS
Practice Location Address:

5100 GAMBLE DR , SUITE 125
ST LOUIS PARK, MN
55416-1521

Practice Phone: 952-465-0105
Practice Fax: 952-465-0106

1073589123 — JENNIFER RAE EGGERS PA
Practice Location Address:

5100 GAMBLE DR , SUITE 100
ST LOUIS PARK, MN
55416-1521

Practice Phone: 952-541-2500
Practice Fax: 952-541-2626

1194886002 — GROUP HEALTH PLAN INC.
Practice Location Address:

1665 UTICA AVENUE SOUTH , SUITE 100
ST LOUIS PARK, MN
55416-1521

Practice Phone: 952-967-7720
Practice Fax: 952-541-2539

1053466128 — GROUP HEALTH PLAN INC
Practice Location Address:

5100 GAMBLE DR , STE 100
ST LOUIS PARK, MN
55416-1521

Practice Phone: 952-593-0779
Practice Fax: 952-595-6451

1720283237 — PATRICK JAMES PALAN L.C.S.W.
Practice Location Address:

5100 GAMBLE DR , SUITE 100 MAIL STOP 31200A
SAINT LOUIS PARK, MN
55416-1521

Practice Phone: 952-593-8777
Practice Fax: 952-595-6408

1265869606 — DR. LISA THANH TIEU DNP, CNP
Practice Location Address:

5100 GAMBLE DR , SUITE 100
ST LOUIS PARK, MN
55416-1521

Practice Phone: 952-541-2500
Practice Fax: 952-541-2539

Directions to “ DEBRA JEAN WAITE LICSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.