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NPI Code Detail

MEDICARE: JAMES MULLER POWELL L.I.C.S.W.

MEDICARE:   JAMES MULLER POWELL  L.I.C.S.W.
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 Worker00446MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
116M91POOTHERMNBLUE CROSS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174634992
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES MULLER POWELL L.I.C.S.W.
Provider Business Mailing Address
First Line : 673 LOIS LN
Second Line :
City : LINO LAKES
State : MN
Zip : 55014-5498
Country : US
Telephone Number : 612-648-8583
Fax Number : 651-784-7761
Provider Business Practice Location Address
First Line : 7362 UNIVERSITY AVE NE
Second Line : SUITE 101
City : FRIDLEY
State : MN
Zip : 55432-3142
Country : US
Telephone Number : 763-503-3981
Fax Number : 763-503-3981
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 05/13/2008

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