Provider Demographics
NPI:1629016696
Name:ANDERSON, CATHERINE E (MA, LICSW)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:E
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MA, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3920 13TH AVE E
Mailing Address - Street 2:SUITE 6
Mailing Address - City:HIBBING
Mailing Address - State:MN
Mailing Address - Zip Code:55746-3675
Mailing Address - Country:US
Mailing Address - Phone:218-263-7540
Mailing Address - Fax:866-732-0699
Practice Address - Street 1:3920 13TH AVE E
Practice Address - Street 2:SUITE 7
Practice Address - City:HIBBING
Practice Address - State:MN
Practice Address - Zip Code:55746-3675
Practice Address - Country:US
Practice Address - Phone:218-263-7540
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN82141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical