MARY ANN HAVSTAD


Address: 9001 E Blgtn Frwy, Suite 140, Bloomington, MN 55420
Phone: 6125185105

MARY ANN HAVSTAD (NPI# 1568530954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1568530954
Entity Type Individual
Full Name MARY ANN HAVSTAD
Credential M.A. LICSW
Practice Address 9001 E Blgtn Frwy
Suite 140
Bloomington
MN 55420
Mailing Address 3703 Towndale Dr
Bloomington
MN 55431-1047
Practice Telephone 6125185105
Practice Fax Number 9528813588
Mailing Telephone 6125185105
Mailing Fax Number 9528813588
Enumeration Date 2006-12-01
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YM0800X Counselor
Specialization: Mental Health
8300 MN Behavioral Health & Social Service Providers

Office Location

Street Address 9001 E BLGTN FRWY
SUITE 140
City BLOOMINGTON
State MN
Zip Code 55420

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Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

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Competitor

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City BLOOMINGTON
Zip Code 55420

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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