MEDICARE: ALIGN NORTH LLC

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

General Provider Information

NPI Number	:	1619734233
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALIGN NORTH LLC

Provider Business Mailing Address
First Line	:	325 CHESTNUT ST STE 504
Second Line	:
City	:	VIRGINIA
State	:	MN
Zip	:	55792-2523
Country	:	US
Telephone Number	:	218-248-2303
Fax Number	:	218-423-5030

Provider Business Practice Location Address
First Line	:	325 CHESTNUT ST STE 504
Second Line	:
City	:	VIRGINIA
State	:	MN
Zip	:	55792-2523
Country	:	US
Telephone Number	:	218-248-2303
Fax Number	:	218-423-5030

Authorized Official
Title or Position	:	OWNER, PSYCHOTHERAPIST
Name	:	JENNIFER ELMBERG
Credential	:	LICSW
Telephone Number	:	218-248-2303

Provider Enumeration Date	:	02/29/2024
Last Update Date	:	02/29/2024

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Directions to “ALIGN NORTH LLC ” Practice Location

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