Provider Demographics
NPI:1417089616
Name:SCHWEIGERT, CONSTANCE JOAN (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:JOAN
Last Name:SCHWEIGERT
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 1:8421 WAYZATA BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55426-1393
Mailing Address - Country:US
Mailing Address - Phone:952-926-0436
Mailing Address - Fax:
Practice Address - Street 1:8421 WAYZATA BLVD STE 140
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55426-1393
Practice Address - Country:US
Practice Address - Phone:952-926-0436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2011-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN70451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN191358100Medicaid
MN6G868SCOtherBLUE CROSS BLUE SHIELD OF
MN6G868SCOtherBLUE CROSS BLUE SHIELD OF