MEDICARE: ANNIE MICHAELS LEUSMAN MSW, 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	9567	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407881824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNIE MICHAELS LEUSMAN MSW, LICSW

Provider Business Mailing Address
First Line	:	205 W 2ND ST STE 125
Second Line	:
City	:	DULUTH
State	:	MN
Zip	:	55802-1928
Country	:	US
Telephone Number	:	218-343-8117
Fax Number	:	218-481-7910

Provider Business Practice Location Address
First Line	:	205 W 2ND ST STE 125
Second Line	:
City	:	DULUTH
State	:	MN
Zip	:	55802-1928
Country	:	US
Telephone Number	:	218-343-8117
Fax Number	:	218-481-7910

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	06/19/2026

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