Provider Demographics
NPI:1689323040
Name:JAMES, JODIE (LICSW)
Entity Type:Individual
Prefix:
First Name:JODIE
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:JODIE
Other - Middle Name:
Other - Last Name:GLASPIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:652 BIELENBERG DR STE 104
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-4416
Mailing Address - Country:US
Mailing Address - Phone:651-925-0610
Mailing Address - Fax:651-925-0619
Practice Address - Street 1:652 BIELENBERG DR STE 104
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-4416
Practice Address - Country:US
Practice Address - Phone:651-925-0610
Practice Address - Fax:651-925-0619
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-22
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN240321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty