Provider Demographics
NPI:1659618437
Name:JUSTEN, MAGGIE ELIZABETH (MSW LICSW)
Entity Type:Individual
Prefix:MRS
First Name:MAGGIE
Middle Name:ELIZABETH
Last Name:JUSTEN
Suffix:
Gender:F
Credentials:MSW LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6830 MACBETH CIR
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2406
Mailing Address - Country:US
Mailing Address - Phone:952-261-3476
Mailing Address - Fax:
Practice Address - Street 1:1385 MENDOTA HEIGHTS RD
Practice Address - Street 2:SUITE 200
Practice Address - City:MENDOTA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55120-1368
Practice Address - Country:US
Practice Address - Phone:651-379-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-13
Last Update Date:2013-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN197261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical