Provider Demographics
NPI:1184772246
Name:NAGER, ELIZABETH EILEEN (MSSW)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:EILEEN
Last Name:NAGER
Suffix:
Gender:F
Credentials:MSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 WAYZATA BLVD
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55426-1338
Mailing Address - Country:US
Mailing Address - Phone:952-212-0304
Mailing Address - Fax:952-448-7098
Practice Address - Street 1:8100 WAYZATA BLVD
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55426-1338
Practice Address - Country:US
Practice Address - Phone:952-212-0304
Practice Address - Fax:952-448-7098
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN024851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN232258700Medicaid
MN267M4NAOtherBLUECROSS BLUESHIELD
MN267M4NAOtherBLUECROSS BLUESHIELD