MEDICARE: NICOLE HERJE 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	21959	MN

General Provider Information

NPI Number	:	1174409130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE HERJE LICSW

Provider Business Mailing Address
First Line	:	7325 W FRANKLIN AVE
Second Line	:
City	:	ST LOUIS PARK
State	:	MN
Zip	:	55426-2013
Country	:	US
Telephone Number	:	763-639-0307
Fax Number	:

Provider Business Practice Location Address
First Line	:	7325 W FRANKLIN AVE
Second Line	:
City	:	ST LOUIS PARK
State	:	MN
Zip	:	55426-2013
Country	:	US
Telephone Number	:	763-639-0307
Fax Number	:

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

Provider Enumeration Date	:	08/14/2025
Last Update Date	:	08/14/2025

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Directions to “ NICOLE HERJE LICSW” Practice Location

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