Provider Demographics
NPI:1184215220
Name:SKJERSETH, ANN P (LICSW)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:P
Last Name:SKJERSETH
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MRS
Other - First Name:ANN
Other - Middle Name:
Other - Last Name:PATNODE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW, MPH
Mailing Address - Street 1:701 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415-1623
Mailing Address - Country:US
Mailing Address - Phone:612-873-9696
Mailing Address - Fax:612-630-8270
Practice Address - Street 1:701 PARK AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415-1623
Practice Address - Country:US
Practice Address - Phone:612-873-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-01
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN262031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical