Provider Demographics
NPI:1235866567
Name:HARTWIG, ANGELA MARY (LICSW)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARY
Last Name:HARTWIG
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:MARY
Other - Last Name:SHERMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:6429 DUNCAN RD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MN
Mailing Address - Zip Code:55779-9799
Mailing Address - Country:US
Mailing Address - Phone:218-410-0909
Mailing Address - Fax:
Practice Address - Street 1:14 N 11TH ST
Practice Address - Street 2:
Practice Address - City:CLOQUET
Practice Address - State:MN
Practice Address - Zip Code:55720-1651
Practice Address - Country:US
Practice Address - Phone:218-879-4583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN229681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical