Jennifer Aeshliman, LICSW

Individual provider Active NPI Clinical Social Worker · Coon Rapids, MN

NPI 1154464477 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1154464477
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
15271 (MN)
Practice address
8990 Springbrook Dr NW
Suite 220
Coon Rapids, MN 55433-5850
Phone
(763) 780-4440
Fax
(763) 780-9219
NPI assigned
Feb 15, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
15271MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Therapy Center, Inc. Past Accepting new patients
Alternative Counseling Clinic Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 15271 MN Yes

Addresses

Primary practice location

8990 Springbrook Dr NW
Suite 220
Coon Rapids, MN 55433-5850

Mailing address

8990 Springbrook Dr NW
Suite 220
Coon Rapids, MN 55433-5850
Phone (763) 780-4440

Other identifiers

IdentifierTypeStateIssuer
610K9AEOtherMNBLUE CROSS OF MINNESOTA

Other providers in Coon Rapids, MN

All providers in Coon Rapids, MN · Clinical Social Worker in Minnesota

Sources for this page

Verify at the official NPI Registry.