MEDICARE: ANN LAUREL PERSON STEELY MSW, LICSW, LADC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	303849	MN
2	104100000X	Social Worker	23463	MN

General Provider Information

NPI Number	:	1821407172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN LAUREL PERSON STEELY MSW, LICSW, LADC

Provider Business Mailing Address
First Line	:	5249 CHICAGO AVE STE 204
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55417-1706
Country	:	US
Telephone Number	:	612-404-0498
Fax Number	:	888-974-8249

Provider Business Practice Location Address
First Line	:	5249 CHICAGO AVE STE 204
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55417-1706
Country	:	US
Telephone Number	:	612-404-0498
Fax Number	:	888-974-8249

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

Provider Enumeration Date	:	08/11/2014
Last Update Date	:	04/06/2026

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