MEDICARE: MR. JAMES P RECHS 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	104100000X	Social Worker	16886	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	:	1437271186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES P RECHS LICSW

Provider Business Mailing Address
First Line	:	2380 WYCLIFF ST STE 102
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55114-1257
Country	:	US
Telephone Number	:	651-647-1083
Fax Number	:	651-642-1230

Provider Business Practice Location Address
First Line	:	2380 WYCLIFF ST STE 102
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55114-1257
Country	:	US
Telephone Number	:	651-647-1083
Fax Number	:	651-642-1230

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

Provider Enumeration Date	:	04/04/2007
Last Update Date	:	04/24/2020

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