Provider Demographics
NPI:1114172715
Name:SPRING, SHODO JANET CEDAR (MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:SHODO
Middle Name:JANET CEDAR
Last Name:SPRING
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 DIVISION ST S
Mailing Address - Street 2:STE C
Mailing Address - City:NORTHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55057-2096
Mailing Address - Country:US
Mailing Address - Phone:507-649-7294
Mailing Address - Fax:651-323-2687
Practice Address - Street 1:401 DIVISION ST S
Practice Address - Street 2:STE C
Practice Address - City:NORTHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55057-2096
Practice Address - Country:US
Practice Address - Phone:507-412-1507
Practice Address - Fax:612-486-8800
Is Sole Proprietor?:No
Enumeration Date:2008-11-24
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN29311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN2931OtherSTATE OF MINNESOTA - LICSW LICENSE NUMBER