Provider Demographics
NPI:1376297663
Name:NEUSTEL, MAUREEN P (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:P
Last Name:NEUSTEL
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:P
Other - Last Name:SIEH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1401 EAST 1ST STREET
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55805-2407
Mailing Address - Country:US
Mailing Address - Phone:218-728-4491
Mailing Address - Fax:218-302-8698
Practice Address - Street 1:810 E 4TH ST
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55805-2147
Practice Address - Country:US
Practice Address - Phone:218-624-5683
Practice Address - Fax:218-624-5736
Is Sole Proprietor?:No
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN281911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical