Provider Demographics
NPI:1790728210
Name:NARUM, DENETTE M (MSW)
Entity Type:Individual
Prefix:
First Name:DENETTE
Middle Name:M
Last Name:NARUM
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 4TH ST S
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-4128
Mailing Address - Country:US
Mailing Address - Phone:218-979-9285
Mailing Address - Fax:
Practice Address - Street 1:1100 32ND AVE S STE B
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-5012
Practice Address - Country:US
Practice Address - Phone:218-979-9285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND57961041C0700X
MN118151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN49D27NAOtherBLUE SHIELD OF MINNESOTA
MN761122600Medicaid
ND20739OtherBLUE SHIELD OF NO. DAKOTA
MN62-53873OtherUNITED BEHAVIORAL HEALTH
MNHP33747OtherHEALTHPARTNERS
MN1028273OtherPREFERREDONE
MN62-53873OtherUNITED BEHAVIORAL HEALTH