Michael Kris Anderson, MSW, LICSW

Individual provider Active NPI Clinical Social Worker · Duluth, MN

NPI 1407599236 · NPPES record last updated Apr 19, 2022

Key facts

NPI
1407599236
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
22391 (MN)
Practice address
1004 W 6TH St
Duluth, MN 55806-2306
Phone
(218) 310-8337
NPI assigned
Apr 19, 2022
Sex
Male
Sole proprietor
Yes

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
22391MNMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 22391 MN Yes

Addresses

Primary practice location

1004 W 6TH St
Duluth, MN 55806-2306

Mailing address

1004 W 6TH St
Duluth, MN 55806-2306
Phone (218) 310-8337

Other providers in Duluth, MN

All providers in Duluth, MN · Clinical Social Worker in Minnesota

Sources for this page

Verify at the official NPI Registry.