MEDICARE: STEPHANIE L CARTWRIGHT-KARLSSON 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	15562	MN

General Provider Information

NPI Number	:	1508835240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE L CARTWRIGHT-KARLSSON LICSW

Provider Business Mailing Address
First Line	:	1723 7TH ST SE
Second Line	:
City	:	SAINT CLOUD
State	:	MN
Zip	:	56304-1355
Country	:	US
Telephone Number	:	612-324-1542
Fax Number	:	612-421-0021

Provider Business Practice Location Address
First Line	:	1723 7TH ST SE
Second Line	:
City	:	SAINT CLOUD
State	:	MN
Zip	:	56304-1355
Country	:	US
Telephone Number	:	612-324-1642
Fax Number	:	612-421-0021

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

Provider Enumeration Date	:	03/15/2006
Last Update Date	:	09/04/2023

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