Provider Demographics
NPI:1548432891
Name:JORSTAD, SUSAN JANE (MSW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:JANE
Last Name:JORSTAD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:JANE
Other - Last Name:SETNIKER-VRAA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:2312 S 6TH ST
Mailing Address - Street 2:SUITE F256/2B W
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55454-1336
Mailing Address - Country:US
Mailing Address - Phone:612-273-8700
Mailing Address - Fax:612-273-9779
Practice Address - Street 1:2312 S 6TH ST
Practice Address - Street 2:SUITE F256/2B W
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1336
Practice Address - Country:US
Practice Address - Phone:612-273-8700
Practice Address - Fax:612-273-9779
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN143161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical