MEDICARE: MELIA JEAN SEDARSKI 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	28135	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	28135	OTHER	MN	LICSW

General Provider Information

NPI Number	:	1396405965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELIA JEAN SEDARSKI LICSW

Provider Business Mailing Address
First Line	:	3269 19TH ST NW STE 360
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55901-7052
Country	:	US
Telephone Number	:	507-722-0958
Fax Number	:

Provider Business Practice Location Address
First Line	:	3269 19TH ST NW STE 360
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55901-7052
Country	:	US
Telephone Number	:	507-722-0958
Fax Number	:

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

Provider Enumeration Date	:	12/23/2021
Last Update Date	:	01/12/2026

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