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NPI Code Detail

MEDICARE: ROSALIN ARDELE CHREST LICSW

MEDICARE:   ROSALIN ARDELE CHREST  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
11041C0700XClinical Social Worker15650MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11029315OTHERPREFERRED ONE
2HP34501OTHERHEALTH PARTNERS
36261828OTHERUBH
4168060OTHERU CARE
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6407T9CHOTHERMNBCBS

General Provider Information

NPI Number : 1073575999
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSALIN ARDELE CHREST LICSW
Provider Business Mailing Address
First Line : 4543 OLIVER AVE N
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55412-1124
Country : US
Telephone Number : 651-260-6512
Fax Number :
Provider Business Practice Location Address
First Line : 4543 OLIVER AVE N
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55412-1124
Country : US
Telephone Number : 651-260-6512
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2006
Last Update Date : 07/16/2024

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Directions to “ ROSALIN ARDELE CHREST LICSW” Practice Location

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