Provider Demographics
NPI:1982828760
Name:NASH, JOANN WINIFRED (LADC)
Entity Type:Individual
Prefix:MS
First Name:JOANN
Middle Name:WINIFRED
Last Name:NASH
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 WOODHILL RD
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-2218
Mailing Address - Country:US
Mailing Address - Phone:952-808-6930
Mailing Address - Fax:
Practice Address - Street 1:6550 YORK AVE S
Practice Address - Street 2:SUITE 620
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2347
Practice Address - Country:US
Practice Address - Phone:952-926-2526
Practice Address - Fax:952-926-6791
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN300492101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)