Provider Demographics
NPI:1518575604
Name:ASP, MADELINE CLAIRE (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:CLAIRE
Last Name:ASP
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:MADELINE
Other - Middle Name:CLAIRE
Other - Last Name:SCHMIDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6600 FRANCE AVE S STE 230
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-1810
Mailing Address - Country:US
Mailing Address - Phone:952-835-2002
Mailing Address - Fax:952-835-9889
Practice Address - Street 1:6600 FRANCE AVE S STE 230
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-1810
Practice Address - Country:US
Practice Address - Phone:952-835-2002
Practice Address - Fax:952-835-9889
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN257011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical