Jean Irene Greseth Kirchner, M.S.W.
Individual provider Active NPI Clinical Social Worker · Park Rapids, MN
NPI 1679587992 · NPPES record last updated May 10, 2010
Key facts
- NPI
- 1679587992
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 03855 (MN)
- Practice address
- 515 Bridge Street East
Park Rapids, MN 56470-1810 - Phone
- (218) 366-9229
- Fax
- (218) 237-2520
- NPI assigned
- Jul 29, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03855 | MN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peterson Medical Clinics, LLC | Past |
Accepting new patients | |
| Upper Mississippi Mental Health Center, Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 03855 | MN | Yes |
Addresses
Primary practice location
515 Bridge Street East
Park Rapids, MN 56470-1810
Mailing address
515 Bridge Street East
Park Rapids, MN 56470-1810
Phone (218) 366-9229
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7528574-00 | Medicaid | MN |
Other names
- Jean Irene Greseth
Other providers in Park Rapids, MN
- Wilma Rae Girtz
- Mary Bachman Godin
- Aron Goraczkowski
- Kelsey Goraczkowski
- Bradley Benjamin Graham
- April Marie Grieger
- Groupworks LLC
- Jacob Earl Grund
- Allison Gustafson
- Guy V Reich PA
All providers in Park Rapids, MN · Clinical Social Worker in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.