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NPI Code Detail

MEDICARE: MRS. ANN CATHERINE KNUTSON JAMES MSW, LCSW

MEDICARE: MRS. ANN CATHERINE KNUTSON JAMES MSW, LCSW
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 Worker149.011881IL

General Provider Information

NPI Number : 1982776662
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANN CATHERINE KNUTSON JAMES MSW, LCSW
Provider Business Mailing Address
First Line : 1639 N ALPINE RD STE 204
Second Line :
City : ROCKFORD
State : IL
Zip : 61107-1481
Country : US
Telephone Number : 779-423-0275
Fax Number :
Provider Business Practice Location Address
First Line : 1639 N ALPINE RD STE 204
Second Line :
City : ROCKFORD
State : IL
Zip : 61107-1481
Country : US
Telephone Number : 779-423-0275
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2006
Last Update Date : 09/23/2014

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