Provider Demographics
NPI:1417914607
Name:NAYMARK, JEAN (LICSW, LMFT)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:
Last Name:NAYMARK
Suffix:
Gender:F
Credentials:LICSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 WILLSON RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55424-1332
Mailing Address - Country:US
Mailing Address - Phone:952-929-0650
Mailing Address - Fax:612-827-7795
Practice Address - Street 1:5200 WILLSON RD
Practice Address - Street 2:SUITE 210
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55424-1332
Practice Address - Country:US
Practice Address - Phone:952-929-0650
Practice Address - Fax:612-827-7795
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLMFT124104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN722OtherSOCIAL WORKER
MN124OtherLMFT