Provider Demographics
NPI:1851633051
Name:MCNATT, JAIME (LICSW)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:MCNATT
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 1:864 STONE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:JORDAN
Mailing Address - State:MN
Mailing Address - Zip Code:55352-4548
Mailing Address - Country:US
Mailing Address - Phone:952-373-1021
Mailing Address - Fax:952-898-5858
Practice Address - Street 1:10591 165TH ST W
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55044-3528
Practice Address - Country:US
Practice Address - Phone:952-373-1021
Practice Address - Fax:952-892-5514
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-26
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN165091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical