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NPI Code Detail

MEDICARE: JOHN DRUSSELL LICSW

MEDICARE:   JOHN  DRUSSELL  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
11041C0700XClinical Social Worker22374MN

General Provider Information

NPI Number : 1730040148
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN DRUSSELL LICSW
Provider Business Mailing Address
First Line : PO BOX 860912
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55486-0912
Country : US
Telephone Number : 507-284-2511
Fax Number :
Provider Business Practice Location Address
First Line : 200 1ST ST SW
Second Line :
City : ROCHESTER
State : MN
Zip : 55905-0001
Country : US
Telephone Number : 507-284-2511
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2025
Last Update Date : 01/26/2026

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Directions to “ JOHN DRUSSELL LICSW” Practice Location

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