Anna Marie Johanson, LICSW | |
1400 Madison Ave Ste 352, Mankato, MN 56001-4458 | |
(507) 387-3195 | |
Not Available |
Full Name | Anna Marie Johanson |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 1400 Madison Ave Ste 352, Mankato, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1023767753 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 15788 (Minnesota) | Primary |
Entity Name | Mankato Clinic Ltd |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1629044029 PECOS PAC ID: 5597677955 Enrollment ID: O20031104000231 |
Mailing Address | Practice Location Address |
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Anna Marie Johanson, LICSW 1400 Madison Ave Ste 352, Mankato, MN 56001-4458 Ph: (507) 389-8502 | Anna Marie Johanson, LICSW 1400 Madison Ave Ste 352, Mankato, MN 56001-4458 Ph: (507) 387-3195 |
K. Robin Newcombe Nelson, LADC, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1025 Marsh St, Mankato, MN 56001 Phone: 507-625-3372 | |
Lacy Osborne, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 100 Warren St # 345, Mankato, MN 56001 Phone: 507-227-4858 Fax: 507-519-2271 | |
Michele J. Larson, MSW, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 104 Serra St, Mankato, MN 56001 Phone: 608-577-5742 | |
Tammy M Gagnon, MSW, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 11 Civic Center Plz Ste 1615, Mankato, MN 56001 Phone: 507-345-4679 Fax: 507-345-8685 | |
Nicole Kristina Lidstrom, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1025 Marsh St, Mankato, MN 56001 Phone: 507-594-2468 | |
Carrie Ann Leggett, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1025 Marsh St, Mankato, MN 56001 Phone: 507-400-4706 |