Provider Demographics
NPI:1578890034
Name:BARGERON, MEIR CHRISTOPHER (LICSW)
Entity Type:Individual
Prefix:
First Name:MEIR
Middle Name:CHRISTOPHER
Last Name:BARGERON
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:CHRISTOPHER
Other - Middle Name:EARL
Other - Last Name:BARGERON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:2431 HENNEPIN AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55405-2605
Mailing Address - Country:US
Mailing Address - Phone:612-746-8543
Mailing Address - Fax:
Practice Address - Street 1:2431 HENNEPIN AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55405-2605
Practice Address - Country:US
Practice Address - Phone:612-746-8543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-04
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN185951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical