Provider Demographics
NPI:1184320632
Name:ALESHIRE OLGREN, KATELYN ADELE (LICSW)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:ADELE
Last Name:ALESHIRE OLGREN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:ADELE
Other - Last Name:ALESHIRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1006 9TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904-5073
Mailing Address - Country:US
Mailing Address - Phone:507-405-0578
Mailing Address - Fax:
Practice Address - Street 1:3265 19TH ST NW STE 310
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-6786
Practice Address - Country:US
Practice Address - Phone:507-405-0578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-06
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN308361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical