Provider Demographics
NPI:1801017066
Name:ROLLOFF, GRACE F (LICSW)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:F
Last Name:ROLLOFF
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 E KELLOGG BLVD, SUITE 7400
Mailing Address - Street 2:
Mailing Address - City:ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-1494
Mailing Address - Country:US
Mailing Address - Phone:651-266-4071
Mailing Address - Fax:651-266-4663
Practice Address - Street 1:160 E KELLOGG BLVD, SUITE 7400
Practice Address - Street 2:
Practice Address - City:ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-1494
Practice Address - Country:US
Practice Address - Phone:651-266-4071
Practice Address - Fax:651-266-4663
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN142321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical